=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013733658
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADONAI HEALTH AND WELLNESS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/27/2024
-----------------------------------------------------
Last Update Date | 05/16/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7635 ASHLEY PARK CT STE 503K
-----------------------------------------------------
City | ORLANDO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32835-6197
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 469-915-9327
-----------------------------------------------------
Fax | 407-550-7232
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16481 SILVERSAW PALM DR
-----------------------------------------------------
City | WINTER GARDEN
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 34787-9521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | AL BERRY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 469-915-4211
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------