| Living Well Medical Practice Llc | |
|
7136 S Military Trl Ste 10 Lake Worth FL 33463-7812 | |
| (561) 358-1722 | |
| Not Available |
| Full Name | Living Well Medical Practice Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 7136 S Military Trl Ste 10, Lake Worth, Florida |
| Authorized Official Name and Position | Joan Williamson (OWNER) |
| Authorized Official Contact | 5613581722 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Well Medical Practice Llc 7136 S Military Trl Ste 10 Lake Worth FL 33463-7812 Ph: (561) 358-1722 | Living Well Medical Practice Llc 7136 S Military Trl Ste 10 Lake Worth FL 33463-7812 Ph: (561) 358-1722 |
| NPI Number | 1538781455 |
|---|---|
| Provider Enumeration Date | 05/13/2020 |
| Last Update Date | 11/24/2020 |
| Medicare PECOS PAC ID | 1951712041 |
|---|---|
| Medicare Enrollment ID | O20201120001552 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538781455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Joan Elaine Williamson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578930285 PECOS PAC ID: 0547570731 Enrollment ID: I20151029002258 |
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