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General NPI Number Information
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NPI Number | 1851858161
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Entity Type | Organization
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Legal Business Name | GRACE HEALTH AND WELLNESS SPECIALISTS
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Dates
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Enumeration Date | 02/22/2019
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Last Update Date | 02/22/2019
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Provider Practice Location Address
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Address Line | 412 W NOBLE AVE
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City | WILLISTON
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State | FL
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Zip | 32696-2034
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Country | US
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Telephone | 352-528-3736
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Fax | 352-528-3211
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Provider Business Mailing Address
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Address Line | 1039 NE 25TH ST
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City | OCALA
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State | FL
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Zip | 34470-3788
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Country | US
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Telephone | 352-622-2681
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEAMARIE KALFS
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Credential | NP
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Telephone | 352-528-3736
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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