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General NPI Number Information
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NPI Number | 1417876053
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Entity Type | Organization
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Legal Business Name | CITY OF SANFORD WELLNESS CENTER POWERED BY WECARE TLC
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 1403 MEDICAL PLAZA DR STE 205
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City | SANFORD
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State | FL
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Zip | 32771-1047
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Country | US
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Telephone | 689-331-8359
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Fax | 407-804-2971
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Provider Business Mailing Address
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Address Line | 1403 MEDICAL PLAZA DR STE 205
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City | SANFORD
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State | FL
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Zip | 32771-1047
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Country | US
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Telephone | 689-331-8359
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Fax | 407-804-2971
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Authorized Official
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Title or Position | CLINICAL TRAINING & QA MANAGER
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Name | KRISTENE SUMMERS DENTLER
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Credential | BSN RN
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Telephone | 256-684-7273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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