MEDICARE: ACV 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	363LP2300X	Primary Care Nurse Practitioner

General Provider Information

NPI Number	:	1841153202
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACV WELLNESS LLC

Provider Business Mailing Address
First Line	:	3746 RACCOON RD
Second Line	:
City	:	ZOLFO SPRINGS
State	:	FL
Zip	:	33890-6712
Country	:	US
Telephone Number	:
Fax Number	:	863-774-1645

Provider Business Practice Location Address
First Line	:	3746 RACCOON RD
Second Line	:
City	:	ZOLFO SPRINGS
State	:	FL
Zip	:	33890-6712
Country	:	US
Telephone Number	:	305-510-9076
Fax Number	:	863-774-1645

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ALIELKIS MENDEZ
Credential	:	APRN
Telephone Number	:	305-510-9076

Provider Enumeration Date	:	12/03/2025
Last Update Date	:	12/04/2025

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