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General NPI Number Information
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NPI Number | 1477419190
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Entity Type | Organization
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Legal Business Name | CENTRAL FLORIDA WELLNESS
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Dates
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Enumeration Date | 12/26/2025
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Last Update Date | 12/26/2025
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Provider Practice Location Address
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Address Line | 3202 W KENNEDY BLVD STE 2
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City | TAMPA
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State | FL
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Zip | 33609-3245
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Country | US
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Telephone | 407-226-2993
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Fax |
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Provider Business Mailing Address
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Address Line | 3202 W KENNEDY BLVD STE 2
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City | TAMPA
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State | FL
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Zip | 33609-3245
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Country | US
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Telephone | 407-226-2993
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN T SHORTLY
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Credential |
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Telephone | 863-559-3434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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