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General NPI Number Information
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NPI Number | 1235001447
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Entity Type | Organization
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Legal Business Name | THRIVEWELL MEDICAL CENTER LLC
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 878 ARTHUR ST
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City | IMMOKALEE
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State | FL
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Zip | 34142-2784
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Country | US
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Telephone | 239-920-3588
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Fax | 844-670-5427
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Provider Business Mailing Address
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Address Line | 878 ARTHUR ST
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City | IMMOKALEE
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State | FL
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Zip | 34142-2784
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Country | US
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Telephone | 239-920-3588
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Fax | 844-670-5427
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Authorized Official
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Title or Position | OWNER
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Name | NATALIE ASHTON TYLER
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Credential |
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Telephone | 239-920-3588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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