=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699687855
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | 518 ORANGE, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/21/2026
-----------------------------------------------------
Last Update Date | 09/21/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 635 CAMBRIDGE CT
-----------------------------------------------------
City | LONGWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32750-3901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 332-264-9947
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 635 CAMBRIDGE CT
-----------------------------------------------------
City | LONGWOOD
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32750-3901
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 332-264-9947
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | PAULA MARIE WELLS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 332-264-9947
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------