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General NPI Number Information
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NPI Number | 1891592440
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Entity Type | Organization
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Legal Business Name | ALTERRA WELLNESS CENTER
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Dates
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Enumeration Date | 02/28/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 817 NW 56TH TER STE D
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City | GAINESVILLE
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State | FL
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Zip | 32605-6418
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Country | US
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Telephone | 845-598-6225
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Fax | 877-202-3150
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Provider Business Mailing Address
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Address Line | 914 S 15TH AVE
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City | HOLLYWOOD
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State | FL
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Zip | 33020-6129
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Country | US
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Telephone | 845-598-6225
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CIPORA MOSKOWITZ
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Credential |
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Telephone | 845-598-6225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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