| Cognitive Health & Wellness, Llc | |
|
838 W Desoto St Unit 8h Clermont FL 34711-2110 | |
| (352) 505-1788 | |
| (321) 594-7656 |
| Full Name | Cognitive Health & Wellness, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 838 W Desoto St Unit 8h, Clermont, Florida |
| Authorized Official Name and Position | Sharon Anna Walker (REGISTERED AGENT) |
| Authorized Official Contact | 3522237779 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cognitive Health & Wellness, Llc 838 W Desoto St Unit 8h Clermont FL 34711-2110 Ph: (352) 505-1788 | Cognitive Health & Wellness, Llc 838 W Desoto St Unit 8h Clermont FL 34711-2110 Ph: (352) 505-1788 |
| NPI Number | 1194325969 |
|---|---|
| Provider Enumeration Date | 10/29/2020 |
| Last Update Date | 11/01/2023 |
| Certification Date | 11/01/2023 |
| Medicare PECOS PAC ID | 3779997077 |
|---|---|
| Medicare Enrollment ID | O20210128000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194325969 | NPI | - | NPPES |
| 006600700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Sharon Anna Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487835534 PECOS PAC ID: 6507059177 Enrollment ID: I20101019000915 |
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