| Blissful Rejuvenation, Inc. | |
|
216 W Hickory St Arcadia FL 34266-3904 | |
| (863) 491-1020 | |
| (863) 491-1440 |
| Full Name | Blissful Rejuvenation, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 216 W Hickory St, Arcadia, Florida |
| Authorized Official Name and Position | Kimberly Diane Gunter Davis (OWNER) |
| Authorized Official Contact | 8634448511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blissful Rejuvenation, Inc. 216 W Hickory St Arcadia FL 34266-3904 Ph: (863) 491-1020 | Blissful Rejuvenation, Inc. 216 W Hickory St Arcadia FL 34266-3904 Ph: (863) 491-1020 |
| NPI Number | 1467228932 |
|---|---|
| Provider Enumeration Date | 11/27/2023 |
| Last Update Date | 11/27/2023 |
| Medicare PECOS PAC ID | 1456798214 |
|---|---|
| Medicare Enrollment ID | O20240328001867 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467228932 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Kimberly Diane Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265970784 PECOS PAC ID: 5890055586 Enrollment ID: I20180126001102 |
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