EXTRACARE & WELLNESS LLC NPI 1417501040

NPI Information

NPI: 1417501040
Provider Name: EXTRACARE & WELLNESS LLC
Classification: Family Medicine - 207QA0505X
Entity Type: Organization

Specialization: Adult Medicine

Address:
1410 N PINE HILLS RD
ORLANDO, FL
ZIP 32808
Phone: (321) 246-5358
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EXTRACARE & WELLNESS LLC is an adult medicine family medicine in Orlando, FL. The provider is the National Uniform Claim Committee (NUCC) recommends code 207QA0505X not be used. Choose a more appropriate code. EXTRACARE & WELLNESS LLC NPI is 1417501040. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1410 N PINE HILLS RD
ORLANDO, FL
ZIP 32808-408
Phone: (321) 246-5358

The provider's authorized official is Kettia Cadet Cherenfant .
The authorized official title is Owner and has the following contact phone number (321) 246-5358.

The enumeration date for this NPI number is 7/31/2019 and was last updated on 7/15/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0505X	Family Medicine	Adult Medicine			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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