Healthcare Provider Details
I. General information
NPI: 1912718982
Provider Name (Legal Business Name): TOTALWELL HEALTH CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/17/2025
Last Update Date: 08/24/2025
Certification Date: 08/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1425 TUSKAWILLA RD STE 221
WINTER SPRINGS FL
32708-5289
US
IV. Provider business mailing address
1425 TUSKAWILLA RD STE 221
WINTER SPRINGS FL
32708-5289
US
V. Phone/Fax
- Phone: 910-257-9947
- Fax:
- Phone: 407-775-5315
- Fax: 855-576-5105
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JOSEPH
PATRICK
JOHNSON
Title or Position: PHYSICIAN/ CO-OWNER
Credential: MD
Phone: 910-257-9947