Provider Demographics
NPI:1700262698
Name:PATIENT CENTERED HEALTH CARE AND WELLNESS LLC
Entity type:Organization
Organization Name:PATIENT CENTERED HEALTH CARE AND WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:GROW
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:352-267-8897
Mailing Address - Street 1:15572 SE 138TH TER
Mailing Address - Street 2:PO BOX 431
Mailing Address - City:WEIRSDALE
Mailing Address - State:FL
Mailing Address - Zip Code:32195-4428
Mailing Address - Country:US
Mailing Address - Phone:352-267-8897
Mailing Address - Fax:321-249-0505
Practice Address - Street 1:108 N MAGNOLIA AVE STE 324
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475-6642
Practice Address - Country:US
Practice Address - Phone:352-267-8897
Practice Address - Fax:321-249-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-03
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9326861363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty