| Restoring Wellness Primary Care Llc | |
|
10597 Us Highway 19 N Pinellas Park FL 33782-3413 | |
| (727) 351-1700 | |
| (727) 351-1701 |
| Full Name | Restoring Wellness Primary Care Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 10597 Us Highway 19 N, Pinellas Park, Florida |
| Authorized Official Name and Position | Jaimie Lousie Mickey (OWNER PHYSICIAN) |
| Authorized Official Contact | 8133625748 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Restoring Wellness Primary Care Llc 5044 Dover St Ne St Petersburg FL 33703-3215 Ph: (813) 362-5748 | Restoring Wellness Primary Care Llc 10597 Us Highway 19 N Pinellas Park FL 33782-3413 Ph: (727) 351-1700 |
| NPI Number | 1467977827 |
|---|---|
| Provider Enumeration Date | 08/07/2017 |
| Last Update Date | 10/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467977827 | NPI | - | NPPES |
| 000994100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | ME103083 (Florida) | Primary |
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