Healthcare Provider Details

I. General information

NPI: 1881509420
Provider Name (Legal Business Name): ELEV8 PHYSICAL WELLNESS AND REHABILITATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10759 EVENING WIND CT
COLUMBIA MD
21044-2413
US

IV. Provider business mailing address

10759 EVENING WIND CT
COLUMBIA MD
21044-2413
US

V. Phone/Fax

Practice location:
  • Phone: 424-644-5061
  • Fax:
Mailing address:
  • Phone: 424-644-5061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOCELYN SHEILA FERNANDEZ
Title or Position: OWNER
Credential: DPT
Phone: 424-644-5061