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NPI Code Detail

MEDICARE: INNER WELLNESS CENTERS OF FLORIDA, LLC

MEDICARE: INNER WELLNESS CENTERS OF FLORIDA, LLC
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
1111N00000XChiropractorCH9771FL
2208D00000XGeneral Practice Physician

General Provider Information

NPI Number : 1447599907
Entity Type Code : Organization
Provider Name (Legal Business Name) : INNER WELLNESS CENTERS OF FLORIDA, LLC
Provider Business Mailing Address
First Line : 2202 SW NEWPORT ISLES BLVD
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34953-4577
Country : US
Telephone Number : 772-577-6640
Fax Number :
Provider Business Practice Location Address
First Line : 6837 S FEDERAL HWY
Second Line :
City : PORT SAINT LUCIE
State : FL
Zip : 34952-1443
Country : US
Telephone Number : 772-577-6640
Fax Number : 772-494-7268
Authorized Official
Title or Position : CEO
Name : DR. SUSAN PARKER SANDERS
Credential : DC
Telephone Number : 772-577-6640
Provider Enumeration Date : 02/04/2013
Last Update Date : 02/20/2014

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Directions to “INNER WELLNESS CENTERS OF FLORIDA, LLC ” Practice Location

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