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General NPI Number Information
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NPI Number | 1902351653
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Entity Type | Organization
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Legal Business Name | LEVERONE WELLNESS, INC.
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Dates
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Enumeration Date | 08/23/2016
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 3950 3RD ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-6123
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Country | US
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Telephone | 727-823-4663
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Fax | 727-822-2329
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Provider Business Mailing Address
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Address Line | 3950 3RD ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33703-6123
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Country | US
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Telephone | 727-823-4663
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Fax | 727-822-2329
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANDREW MICHAEL LEVERONE
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Credential | D.C.
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Telephone | 727-823-4663
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH10411
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License Number State | FL
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