Healthcare Provider Details

I. General information

NPI: 1528260296
Provider Name (Legal Business Name): THE CENTER FOR ADVANCED WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 SOUTH TAMIAMI TRAIL SUITE C
SARASOTA FL
34239-3805
US

IV. Provider business mailing address

PO BOX 49766
SARASOTA FL
34230-6766
US

V. Phone/Fax

Practice location:
  • Phone: 941-330-8553
  • Fax: 941-330-9853
Mailing address:
  • Phone: 941-330-8553
  • Fax: 941-330-9853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH 7524
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME 30555
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP 2012
License Number StateFL

VIII. Authorized Official

Name: LORI K FEIL
Title or Position: OFFICE MANAGER
Credential:
Phone: 941-330-8553