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General NPI Number Information
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NPI Number | 1962068783
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Entity Type | Organization
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Legal Business Name | HEALTH & WELLNESS PLACE
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Dates
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Enumeration Date | 05/16/2019
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Last Update Date | 12/16/2022
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Provider Practice Location Address
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Address Line | 2295 S HIAWASSEE RD STE 210
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City | ORLANDO
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State | FL
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Zip | 32835-8748
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Country | US
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Telephone | 407-705-3424
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 474
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City | OCOEE
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State | FL
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Zip | 34761-0474
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MULVA PEARSON
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Credential | MD
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Telephone | 407-705-3424
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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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