Provider Demographics
NPI:1831082700
Name:WELLNESS COLLECTIVE
Entity type:Organization
Organization Name:WELLNESS COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ORTEGA MARTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:939-223-7413
Mailing Address - Street 1:4327 AVE. ISLA VERDE, APT 1205
Mailing Address - Street 2:BEACH TOWER
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00979
Mailing Address - Country:US
Mailing Address - Phone:787-709-6205
Mailing Address - Fax:
Practice Address - Street 1:1064 AVE PONCE DE LEON STE 205
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907-3719
Practice Address - Country:US
Practice Address - Phone:939-223-7413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-30
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty