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NPI Code Detail

MEDICARE: UNCONDITIONAL LOVE INC.

MEDICARE: UNCONDITIONAL LOVE INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1265455133
Entity Type Code : Organization
Provider Name (Legal Business Name) : UNCONDITIONAL LOVE INC.
Provider Business Mailing Address
First Line : 1495 N HARBOR CITY BLVD STE E
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-6572
Country : US
Telephone Number : 321-253-0846
Fax Number : 321-253-1004
Provider Business Practice Location Address
First Line : 1509 N HARBOR CITY BLVD
Second Line :
City : MELBOURNE
State : FL
Zip : 32935-6572
Country : US
Telephone Number : 321-253-0846
Fax Number : 321-253-1004
Authorized Official
Title or Position : CEO
Name : JESSICA SEIDITA
Credential :
Telephone Number : 321-259-8928
Provider Enumeration Date : 07/25/2006
Last Update Date : 01/08/2024

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