MEDICARE: LEVERONE WELLNESS, INC.

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	111N00000X	Chiropractor	CH10411	FL

General Provider Information

NPI Number	:	1902351653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEVERONE WELLNESS, INC.

Provider Business Mailing Address
First Line	:	3950 3RD ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33703-6123
Country	:	US
Telephone Number	:	727-823-4663
Fax Number	:	727-822-2329

Provider Business Practice Location Address
First Line	:	3950 3RD ST N
Second Line	:
City	:	SAINT PETERSBURG
State	:	FL
Zip	:	33703-6123
Country	:	US
Telephone Number	:	727-823-4663
Fax Number	:	727-822-2329

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ANDREW MICHAEL LEVERONE
Credential	:	D.C.
Telephone Number	:	727-823-4663

Provider Enumeration Date	:	08/23/2016
Last Update Date	:	08/23/2016

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Directions to “LEVERONE WELLNESS, INC. ” Practice Location

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