Healthcare Provider Details

I. General information

NPI: 1699283887
Provider Name (Legal Business Name): HEALTH AND WELLNESS URGENT CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2018
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1965 CAPITAL CIR NE STE 200
TALLAHASSEE FL
32308-8402
US

IV. Provider business mailing address

1965 CAPITAL CIR NE STE 200
TALLAHASSEE FL
32308-8402
US

V. Phone/Fax

Practice location:
  • Phone: 850-656-2006
  • Fax: 850-656-2820
Mailing address:
  • Phone: 850-656-2006
  • Fax: 850-656-2820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: YVETTE MIGNON
Title or Position: PRESIDENT
Credential: MD
Phone: 850-656-2006