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General NPI Number Information
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NPI Number | 1053068205
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Entity Type | Organization
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Legal Business Name | UNIVERSAL TELE-HEALTH & WELLNESS INC
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Dates
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Enumeration Date | 03/08/2022
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Last Update Date | 03/08/2022
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Provider Practice Location Address
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Address Line | 2128 CLERMONT ST
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City | WINTER HAVEN
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State | FL
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Zip | 33881-8264
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Country | US
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Telephone | 863-282-6441
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 482
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City | LAKE HAMILTON
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State | FL
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Zip | 33851-0482
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Country | US
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Telephone | 863-282-6441
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | SHIRLEY O WHITE-CAMPBELL
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Credential |
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Telephone | 863-282-6441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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