| Papillon Health And Wellness Llc | |
|
643 Sw Granadeer St Port Saint Lucie FL 34983-8772 | |
| (561) 412-9281 | |
| Not Available |
| Full Name | Papillon Health And Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 643 Sw Granadeer St, Port Saint Lucie, Florida |
| Authorized Official Name and Position | Bonnie Russo (OWNER/PROVIDER) |
| Authorized Official Contact | 5614129281 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Papillon Health And Wellness Llc 643 Sw Granadeer St Port Saint Lucie FL 34983-8772 Ph: (561) 412-9281 | Papillon Health And Wellness Llc 643 Sw Granadeer St Port Saint Lucie FL 34983-8772 Ph: (561) 412-9281 |
| NPI Number | 1639892854 |
|---|---|
| Provider Enumeration Date | 09/22/2022 |
| Last Update Date | 09/22/2022 |
| Certification Date | 09/22/2022 |
| Medicare PECOS PAC ID | 3779949508 |
|---|---|
| Medicare Enrollment ID | O20230519001425 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639892854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Bonnie Russo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366922288 PECOS PAC ID: 4688030414 Enrollment ID: I20230519001509 |
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