MEDICARE: ALORA HEALTH, WELLNESS & AESTHETICS

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	207VG0400X	Gynecology Physician
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1639921984
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALORA HEALTH, WELLNESS & AESTHETICS

Provider Business Mailing Address
First Line	:	5720 W 1ST SQ SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-2256
Country	:	US
Telephone Number	:	614-556-8886
Fax Number	:

Provider Business Practice Location Address
First Line	:	5720 W 1ST SQ SW
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32968-2256
Country	:	US
Telephone Number	:	614-556-8886
Fax Number	:	361-360-6589

Authorized Official
Title or Position	:	APRN
Name	:	CHARISSA WRIGHT
Credential	:	APRN
Telephone Number	:	614-556-8886

Provider Enumeration Date	:	04/02/2024
Last Update Date	:	04/02/2024

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