| Mediwell Llc | |
|
921 Town Center Dr Orange City FL 32763-8311 | |
| (646) 346-4709 | |
| Not Available |
| Full Name | Mediwell Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 921 Town Center Dr, Orange City, Florida |
| Authorized Official Name and Position | Janet Heron (OWNER) |
| Authorized Official Contact | 6463464709 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mediwell Llc 1742 S Woodland Blvd Deland FL 32720-7915 Ph: (646) 346-4709 | Mediwell Llc 921 Town Center Dr Orange City FL 32763-8311 Ph: (646) 346-4709 |
| NPI Number | 1053187179 |
|---|---|
| Provider Enumeration Date | 11/29/2023 |
| Last Update Date | 11/29/2023 |
| Medicare PECOS PAC ID | 1456793637 |
|---|---|
| Medicare Enrollment ID | O20240521001172 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053187179 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Janet Heron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255806840 PECOS PAC ID: 7214272145 Enrollment ID: I20200309001510 |
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