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General NPI Number Information
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NPI Number | 1538671102
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Entity Type | Organization
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Legal Business Name | WALK N WELLNESS, LLC
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Dates
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Enumeration Date | 11/03/2017
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Last Update Date | 11/03/2017
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Provider Practice Location Address
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Address Line | 4691 VAN DYKE RD
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City | LUTZ
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State | FL
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Zip | 33558-4880
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Country | US
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Telephone | 813-265-0642
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Fax |
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Provider Business Mailing Address
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Address Line | 2118 RAMBLEWOOD CT
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City | BRANDON
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State | FL
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Zip | 33510-2122
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PATRICK L AGDAMAG
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Credential | MD
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Telephone | 813-758-6564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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