Healthcare Provider Details

I. General information

NPI: 1275254591
Provider Name (Legal Business Name): THE WELLNESS HOUSE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1685 LEE RD STE 100B
WINTER PARK FL
32789-2214
US

IV. Provider business mailing address

1685 LEE RD STE 100B
WINTER PARK FL
32789-2214
US

V. Phone/Fax

Practice location:
  • Phone: 407-961-7616
  • Fax: 407-961-7718
Mailing address:
  • Phone: 407-961-7616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. ROSANELL MERCED
Title or Position: CHIROPRACTOR / OWNER
Credential: DC
Phone: 407-961-7616