Healthcare Provider Details

I. General information

NPI: 1306787668
Provider Name (Legal Business Name): ANIMA WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 ALOMA AVE STE A
WINTER PARK FL
32792-3707
US

IV. Provider business mailing address

3015 ALOMA AVE STE A
WINTER PARK FL
32792-3707
US

V. Phone/Fax

Practice location:
  • Phone: 407-383-4691
  • Fax:
Mailing address:
  • Phone: 407-383-4691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WANYAN CHEN
Title or Position: OWNER
Credential: L.A.C
Phone: 312-646-8917