Healthcare Provider Details

I. General information

NPI: 1013678242
Provider Name (Legal Business Name): URBAN PLANTATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5759 SE FEDERAL HWY
STUART FL
34997-8545
US

IV. Provider business mailing address

5831 SE RIVERBOAT DR # 413
STUART FL
34997-1508
US

V. Phone/Fax

Practice location:
  • Phone: 772-837-0810
  • Fax:
Mailing address:
  • Phone: 772-837-0810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. HEATHER JEANINE WALDEN
Title or Position: D.O.M.
Credential: ORIENTAL MEDICINE
Phone: 772-837-0810