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General NPI Number Information
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NPI Number | 1184440836
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Entity Type | Organization
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Legal Business Name | ADVANCED WELLNESS ASSOCIATES PLLC
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Dates
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Enumeration Date | 11/26/2024
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Last Update Date | 11/26/2024
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Provider Practice Location Address
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Address Line | 4131 NW 28TH LN STE 4
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City | GAINESVILLE
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State | FL
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Zip | 32606-6681
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Country | US
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Telephone | 352-681-9652
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Fax |
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Provider Business Mailing Address
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Address Line | 4131 NW 28TH LN STE 4
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City | GAINESVILLE
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State | FL
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Zip | 32606-6681
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Country | US
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Telephone | 352-681-9652
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MORGAN M.E. BURNS
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Credential | APRN
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Telephone | 352-681-9652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 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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