Provider Demographics
NPI:1245112663
Name:VIP WOUNDCARE INC DBA AZALEA WELLNESS
Entity type:Organization
Organization Name:VIP WOUNDCARE INC DBA AZALEA WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:MOORE
Authorized Official - Last Name:FAINE
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE PRACTITIONER
Authorized Official - Phone:678-468-3856
Mailing Address - Street 1:1683 N HANCOCK RD STE 103-132
Mailing Address - Street 2:
Mailing Address - City:MINNEOLA
Mailing Address - State:FL
Mailing Address - Zip Code:34715-8189
Mailing Address - Country:US
Mailing Address - Phone:678-468-3856
Mailing Address - Fax:
Practice Address - Street 1:1600 EVENING SUMMIT CIR
Practice Address - Street 2:
Practice Address - City:MINNEOLA
Practice Address - State:FL
Practice Address - Zip Code:34715-9104
Practice Address - Country:US
Practice Address - Phone:678-468-3856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Single Specialty