Provider Demographics
NPI:1033773346
Name:SUNBELT WELLNESS INSTITUTE, LLC
Entity Type:Organization
Organization Name:SUNBELT WELLNESS INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:KALYNYCH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNA, APRN
Authorized Official - Phone:904-328-6749
Mailing Address - Street 1:8833 PERIMETER PARK BLVD STE 1004
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1114
Mailing Address - Country:US
Mailing Address - Phone:904-328-6749
Mailing Address - Fax:904-503-1960
Practice Address - Street 1:8833 PERIMETER PARK BLVD STE 1004
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1114
Practice Address - Country:US
Practice Address - Phone:904-328-6749
Practice Address - Fax:904-503-1960
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty