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General NPI Number Information
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NPI Number | 1427934744
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Entity Type | Organization
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Legal Business Name | 4 HEALTH NUTS FL LLC
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Dates
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Enumeration Date | 08/13/2025
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 901 INDUSTRIAL DR STE 2195
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City | WILDWOOD
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State | FL
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Zip | 34785-4707
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Country | US
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Telephone | 917-579-5441
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Fax | 646-514-7520
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Provider Business Mailing Address
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Address Line | 500 POST RD E FL 2
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City | WESTPORT
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State | CT
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Zip | 06880-4431
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Country | US
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Telephone | 917-579-5441
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Fax | 646-514-7520
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Authorized Official
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Title or Position | MEMBER MANAGER
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Name | LANCE DIAMOND
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Credential |
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Telephone | 917-579-5441
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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