Healthcare Provider Details

I. General information

NPI: 1609294776
Provider Name (Legal Business Name): ARIA HEALTH AND WELLNESS INSTITUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2014
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 1ST ST S
ST PETERSBURG FL
33701-4383
US

IV. Provider business mailing address

115 1ST ST S
ST PETERSBURG FL
33701-4383
US

V. Phone/Fax

Practice location:
  • Phone: 727-800-9886
  • Fax: 727-800-9895
Mailing address:
  • Phone: 727-800-9886
  • Fax: 727-800-9895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME118400
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME117606
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH11179
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAP3212
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN9368022
License Number StateFL
# 6
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberME118400
License Number StateFL

VIII. Authorized Official

Name: DR. PATRICK WESTON
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 857-928-2418