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General NPI Number Information
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NPI Number | 1780325563
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Entity Type | Organization
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Legal Business Name | INSIGHTBIO HEALTH AND WELLNESS LLC
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 1059 MAITLAND CENTER COMMONS BLVD STE 102
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City | MAITLAND
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State | FL
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Zip | 32751-7453
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Country | US
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Telephone | 321-376-5364
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Fax |
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Provider Business Mailing Address
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Address Line | 411 WALNUT ST UNIT 17459
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City | GREEN COVE SPRINGS
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State | FL
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Zip | 32043-3443
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Country | US
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Telephone | 914-588-7174
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JENNIFER LANDA
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Credential | MD
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Telephone | 914-588-7174
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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