MEDICARE: BE WELL HOLISTIC CARE, 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	225700000X	Massage Therapist
2	171100000X	Acupuncturist

General Provider Information

NPI Number	:	1700511979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BE WELL HOLISTIC CARE, LLC

Provider Business Mailing Address
First Line	:	417 E JACKSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2805
Country	:	US
Telephone Number	:	407-494-2272
Fax Number	:

Provider Business Practice Location Address
First Line	:	417 E JACKSON ST
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32801-2805
Country	:	US
Telephone Number	:	407-494-2272
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MRS. MELISSA K SONNENSCHEIN
Credential	:
Telephone Number	:	407-494-2272

Provider Enumeration Date	:	07/20/2022
Last Update Date	:	08/08/2022

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