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General NPI Number Information
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NPI Number | 1154088391
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Entity Type | Organization
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Legal Business Name | FLUID HYDRATION & WELLNESS, PLLC
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Dates
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Enumeration Date | 11/22/2021
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 1630 OAKHURST COMMONS DR SUITE 201 STE 110
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City | CHARLOTTE
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State | NC
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Zip | 28205-6382
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Country | US
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Telephone | 704-258-3722
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Fax |
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Provider Business Mailing Address
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Address Line | 401 HAWTHORNE LN STE 110200
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City | CHARLOTTE
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State | NC
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Zip | 28204-2484
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Country | US
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Telephone | 704-258-3722
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CYNTHIA AMBROISE
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Credential |
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Telephone | 704-258-3722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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