Healthcare Provider Details

I. General information

NPI: 1992611511
Provider Name (Legal Business Name): MAILE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2026
Last Update Date: 08/22/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3658 GALILEO DR STE 106
TRINITY FL
34655-1856
US

IV. Provider business mailing address

3658 GALILEO DR STE 106
TRINITY FL
34655-1856
US

V. Phone/Fax

Practice location:
  • Phone: 727-428-5283
  • Fax: 877-284-7618
Mailing address:
  • Phone: 727-428-5283
  • Fax: 877-284-7618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. LEANNE ZAHN
Title or Position: OWNER
Credential: APRN, FNP-BC
Phone: 727-428-5283