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General NPI Number Information
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NPI Number | 1760316186
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Entity Type | Organization
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Legal Business Name | WHITE KOI WELLNESS
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 1551 SANDSPUR RD
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City | MAITLAND
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State | FL
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Zip | 32751-6138
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Country | US
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Telephone | 941-284-8497
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 SANDSPUR RD
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City | MAITLAND
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State | FL
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Zip | 32751-6138
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Country | US
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Telephone | 941-284-8497
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Fax |
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Authorized Official
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Title or Position | DIETITIAN
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Name | MIKAELA COEL
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Credential | MPH, RD, LDN
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Telephone | 941-284-8497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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