Wellness Within | |
2202 25th Ave Ste B Gulfport MS 39501-4520 | |
(228) 206-6843 | |
(228) 206-6843 |
Full Name | Wellness Within |
---|---|
Speciality | Internal Medicine |
Location | 2202 25th Ave Ste B, Gulfport, Mississippi |
Authorized Official Name and Position | Liana Rodriguez (PHYSICIAN & OWNER) |
Authorized Official Contact | 2282066843 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Wellness Within Po Box 253 Gulfport MS 39502-0253 Ph: (228) 206-6843 | Wellness Within 2202 25th Ave Ste B Gulfport MS 39501-4520 Ph: (228) 206-6843 |
NPI Number | 1598294514 |
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Provider Enumeration Date | 06/05/2017 |
Last Update Date | 06/05/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598294514 | NPI | - | NPPES |
05351053 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 23342 (Mississippi) | Primary |
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