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General NPI Number Information
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NPI Number | 1588908834
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Entity Type | Organization
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Legal Business Name | WELLNESS DIMENSIONS LLC
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 400 8TH ST N # 2
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City | NAPLES
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State | FL
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Zip | 34102-5519
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Country | US
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Telephone | 239-649-3306
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Fax | 239-649-3393
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Provider Business Mailing Address
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Address Line | 400 8TH ST N # 2
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City | NAPLES
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State | FL
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Zip | 34102-5519
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Country | US
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Telephone | 239-649-3306
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Fax | 239-649-3393
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Authorized Official
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Title or Position | MGR
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Name | KAVITHA GUDUR
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Credential |
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Telephone | 305-487-8140
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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 | ME105338
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License Number State | FL
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