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General NPI Number Information
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NPI Number | 1245112663
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Entity Type | Organization
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Legal Business Name | VIP WOUNDCARE INC DBA AZALEA WELLNESS
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Dates
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Enumeration Date | 07/24/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 1600 EVENING SUMMIT CIR
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City | MINNEOLA
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State | FL
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Zip | 34715-9104
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Country | US
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Telephone | 678-468-3856
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Fax |
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Provider Business Mailing Address
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Address Line | 1683 N HANCOCK RD STE 103-132
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City | MINNEOLA
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State | FL
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Zip | 34715-8189
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Country | US
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Telephone | 678-468-3856
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHELIA MOORE FAINE
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Credential | NURSE PRACTITIONER
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Telephone | 678-468-3856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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