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General NPI Number Information
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NPI Number | 1992610844
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Entity Type | Organization
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Legal Business Name | HART WELLNESS COLLECTIVE LLC
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Dates
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Enumeration Date | 08/17/2026
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Last Update Date | 08/17/2026
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Provider Practice Location Address
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Address Line | 6539 VIA REGINA
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City | BOCA RATON
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State | FL
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Zip | 33433-3911
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Country | US
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Telephone | 703-587-1008
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Fax |
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Provider Business Mailing Address
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Address Line | 6539 VIA REGINA
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City | BOCA RATON
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State | FL
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Zip | 33433-3911
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Country | US
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Telephone | 703-587-1008
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALICIA CORONADO
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Credential |
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Telephone | 703-587-1008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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