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General NPI Number Information
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NPI Number | 1790583300
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Entity Type | Organization
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Legal Business Name | INNER LIGHT WELLNESS LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 1317 EDGEWATER DR # 4828
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City | ORLANDO
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State | FL
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Zip | 32804-6350
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Country | US
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Telephone | 978-272-0077
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Fax | 978-272-0077
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Provider Business Mailing Address
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Address Line | 1317 EDGEWATER DR # 4828
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City | ORLANDO
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State | FL
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Zip | 32804-6350
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Country | US
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Telephone | 978-272-0077
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEIDY ALMONTE
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Credential | LICSW
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Telephone | 978-272-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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