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General NPI Number Information
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NPI Number | 1720875917
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Entity Type | Organization
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Legal Business Name | BV HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 3329 LONG BRANCH DR
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City | NEW CASTLE
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State | PA
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Zip | 16105-2929
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Country | US
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Telephone | 724-944-2070
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Fax |
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Provider Business Mailing Address
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Address Line | 400 N TAMPA ST STE 1550
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City | TAMPA
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State | FL
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Zip | 33602-4737
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Country | US
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Telephone | 724-944-2070
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. SHAWN MICHAEL BULISCO
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Credential | CPA
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Telephone | 724-944-2070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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