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General NPI Number Information
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NPI Number | 1154296267
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Entity Type | Organization
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Legal Business Name | FLO MED SPA AND WELLNESS
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Dates
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Enumeration Date | 10/08/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 111 KILSON DR STE 300
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City | MOORESVILLE
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State | NC
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Zip | 28117-8217
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Country | US
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Telephone | 704-500-0945
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Fax | 704-885-0591
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Provider Business Mailing Address
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Address Line | 111 KILSON DR STE 103
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City | MOORESVILLE
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State | NC
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Zip | 28117-8218
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Country | US
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Telephone | 704-500-0945
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Fax | 704-885-0591
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Authorized Official
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Title or Position | OWNER
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Name | TRIVIA SHARPE
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Credential |
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Telephone | 704-500-3969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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