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General NPI Number Information
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NPI Number | 1316617285
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Entity Type | Organization
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Legal Business Name | GET FIT BY JOURNEY INC
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 01/02/2022
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Provider Practice Location Address
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Address Line | 4101 PARK LAKE ST
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City | ORLANDO
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State | FL
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Zip | 32803-5265
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Country | US
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Telephone | 407-412-6453
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 PARK LAKE ST
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City | ORLANDO
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State | FL
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Zip | 32803-5265
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Country | US
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Telephone | 407-412-6453
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARK ANTHONY THELWELL
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Credential |
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Telephone | 407-412-6453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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