| Wells Legacy Health & Wellness Llc | |
|
452 Osceola St Ste 106 Altamonte Springs FL 32701-7800 | |
| (321) 306-6755 | |
| Not Available |
| Full Name | Wells Legacy Health & Wellness Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 452 Osceola St Ste 106, Altamonte Springs, Florida |
| Authorized Official Name and Position | Latoya Wells (OWNER) |
| Authorized Official Contact | 3213066755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wells Legacy Health & Wellness Llc 452 Osceola St Ste 106 Altamonte Springs FL 32701-7800 Ph: (321) 306-6755 | Wells Legacy Health & Wellness Llc 452 Osceola St Ste 106 Altamonte Springs FL 32701-7800 Ph: (321) 306-6755 |
| NPI Number | 1609577865 |
|---|---|
| Provider Enumeration Date | 03/15/2023 |
| Last Update Date | 08/02/2024 |
| Medicare PECOS PAC ID | 0042669053 |
|---|---|
| Medicare Enrollment ID | O20231214003650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609577865 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Latoya D Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003112137 PECOS PAC ID: 2769666965 Enrollment ID: I20110413000345 |
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