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General NPI Number Information
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NPI Number | 1861358764
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Entity Type | Organization
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Legal Business Name | MY SELF WELLNESS INS LLC
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Dates
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Enumeration Date | 01/05/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 3541 BONITA BAY BLVD STE 100
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-1703
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Country | US
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Telephone | 239-908-9958
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Fax | 239-319-5729
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Provider Business Mailing Address
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Address Line | 3541 BONITA BAY BLVD STE 100
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City | BONITA SPRINGS
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State | FL
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Zip | 34134-1703
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Country | US
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Telephone | 239-908-9958
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Fax | 239-319-5729
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | JESSICA SEIBERT
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Credential |
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Telephone | 239-908-9958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology 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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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