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General NPI Number Information
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NPI Number | 1225846033
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Entity Type | Organization
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Legal Business Name | ADVANCED WELLNESS OF OCALA
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 2457 SW 27TH AVE
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City | OCALA
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State | FL
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Zip | 34471-0807
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Country | US
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Telephone | 352-216-1871
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 SE 31ST PL
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City | OCALA
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State | FL
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Zip | 34480-1635
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | APRN
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Name | JENNIFER BABOOLALL
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Credential | APRN
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Telephone | 352-216-1871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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