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General NPI Number Information
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NPI Number | 1972175529
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Entity Type | Organization
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Legal Business Name | NUVO WELLNESS & RECOVERY LLC
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | 1400 N HWY A1A STE 105
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City | INDIALANTIC
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State | FL
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Zip | 32903-2736
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Country | US
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Telephone | 321-914-3381
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 N HWY A1A STE 105
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City | INDIALANTIC
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State | FL
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Zip | 32903-2736
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Country | US
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Telephone | 321-914-3381
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DJUNOT DESTINA
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Credential |
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Telephone | 321-914-3381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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