Healthcare Provider Details

I. General information

NPI: 1326712282
Provider Name (Legal Business Name): INTEGRATIVE WELLNESS CENTERS OF SARASOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2021
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 BEE RIDGE RD STE C
SARASOTA FL
34239-6350
US

IV. Provider business mailing address

2426 BEE RIDGE RD STE C
SARASOTA FL
34239-6350
US

V. Phone/Fax

Practice location:
  • Phone: 941-554-6506
  • Fax: 941-315-9922
Mailing address:
  • Phone: 941-554-6506
  • Fax: 941-315-9922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MELISSA LORAINE HARMON
Title or Position: PRESIDENT
Credential: DC
Phone: 941-544-4423