Provider Demographics
NPI:1013178458
Name:REMMEL WELLNESS CENTER
Entity Type:Organization
Organization Name:REMMEL WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:DIESING
Authorized Official - Last Name:REMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-525-1141
Mailing Address - Street 1:6416 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33702-6624
Mailing Address - Country:US
Mailing Address - Phone:727-525-1141
Mailing Address - Fax:727-525-1195
Practice Address - Street 1:6416 9TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33702-6624
Practice Address - Country:US
Practice Address - Phone:727-525-1141
Practice Address - Fax:727-525-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003911261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
T-55641Medicare UPIN