Provider Demographics
NPI:1982595484
Name:ESTELLA BYRD WHITMAN WELLNESS & COMMUNITY RESOURCE CENTER, INC
Entity type:Organization
Organization Name:ESTELLA BYRD WHITMAN WELLNESS & COMMUNITY RESOURCE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LEVONDA
Authorized Official - Middle Name:KATRELL
Authorized Official - Last Name:GOODSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-875-2226
Mailing Address - Street 1:819 NW 7TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34475-6136
Mailing Address - Country:US
Mailing Address - Phone:352-875-2226
Mailing Address - Fax:
Practice Address - Street 1:5664 SW 60TH AVE
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34474-5682
Practice Address - Country:US
Practice Address - Phone:352-703-2226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-12
Last Update Date:2025-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty