Provider Demographics
NPI:1174495295
Name:DELLATORRE HEALTH & WELLNESS LLC
Entity type:Organization
Organization Name:DELLATORRE HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DORA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELLATORRE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:321-305-6968
Mailing Address - Street 1:1260 ROCKLEDGE BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-2728
Mailing Address - Country:US
Mailing Address - Phone:321-305-6968
Mailing Address - Fax:321-335-1763
Practice Address - Street 1:1260 ROCKLEDGE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-2728
Practice Address - Country:US
Practice Address - Phone:321-305-6968
Practice Address - Fax:321-335-1763
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty