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General NPI Number Information
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NPI Number | 1265360580
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Entity Type | Organization
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Legal Business Name | THE MODERN HEART AND WELLNESS CLINIC
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Dates
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Enumeration Date | 05/08/2026
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Last Update Date | 05/08/2026
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Provider Practice Location Address
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Address Line | 212 S PINE AVE
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City | INVERNESS
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State | FL
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Zip | 34452-4831
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Country | US
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Telephone | 352-419-6537
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Fax |
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Provider Business Mailing Address
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Address Line | 212 S PINE AVE
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City | INVERNESS
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State | FL
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Zip | 34452-4831
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Country | US
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Telephone | 352-419-6537
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | LAURA A KNAPP
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Credential | APRN
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Telephone | 352-446-9656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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