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General NPI Number Information
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NPI Number | 1235611245
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Entity Type | Organization
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Legal Business Name | WELCOME HOME WELLNESS CENTER LLC
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Dates
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Enumeration Date | 09/06/2018
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Last Update Date | 09/06/2018
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Provider Practice Location Address
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Address Line | 7732 SILVER STAR RD STE 2
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City | ORLANDO
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State | FL
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Zip | 32818
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Country | US
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Telephone | 321-305-2765
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Fax |
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Provider Business Mailing Address
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Address Line | 7732 SILVER STAR RD STE 2
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City | ORLANDO
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State | FL
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Zip | 32818-4752
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Country | US
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Telephone | 321-305-2765
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KETTIA CADET CHERENFANT
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Credential | NP
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Telephone | 321-305-2765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 9237369
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License Number State | FL
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