MEDICARE: AXIS WELLNESS 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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1457283947
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AXIS WELLNESS LLC

Provider Business Mailing Address
First Line	:	508 S HABANA AVE STE 220
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4161
Country	:	US
Telephone Number	:	813-870-0207
Fax Number	:	813-441-7975

Provider Business Practice Location Address
First Line	:	508 S HABANA AVE STE 220
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33609-4161
Country	:	US
Telephone Number	:	813-870-0207
Fax Number	:	813-441-7975

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. LAURA ANISSIAN
Credential	:	MD
Telephone Number	:	813-870-0207

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “AXIS WELLNESS LLC ” Practice Location

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