Provider Demographics
NPI:1548974348
Name:TOTAL HEALTH AND WELLNESS INC.
Entity type:Organization
Organization Name:TOTAL HEALTH AND WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:JOINER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-766-5892
Mailing Address - Street 1:323 S GLEN ARVEN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-6301
Mailing Address - Country:US
Mailing Address - Phone:813-766-5892
Mailing Address - Fax:
Practice Address - Street 1:323 S GLEN ARVEN AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-6301
Practice Address - Country:US
Practice Address - Phone:813-766-5892
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-06
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101543594Medicaid