Healthcare Provider Details

I. General information

NPI: 1962017475
Provider Name (Legal Business Name): IN DUE SEASON WELLNESS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2020
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5034 7TH ST
ZEPHYRHILLS FL
33542-2132
US

IV. Provider business mailing address

5034 7TH ST
ZEPHYRHILLS FL
33542-2132
US

V. Phone/Fax

Practice location:
  • Phone: 813-377-2229
  • Fax: 813-816-6438
Mailing address:
  • Phone: 813-377-2229
  • Fax: 813-816-6438

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code2085U0001X
TaxonomyDiagnostic Ultrasound Physician
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number
License Number StateNULL
# 7
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number StateNULL
# 8
Primary TaxonomyN
Taxonomy Code111NI0013X
TaxonomyIndependent Medical Examiner Chiropractor
License Number
License Number StateNULL

VIII. Authorized Official

Name: LUCIE BRYANT
Title or Position: OWNER
Credential: CPM
Phone: 813-377-2229