Provider Demographics
NPI:1154053908
Name:NATIVA WELLNESS LLC
Entity Type:Organization
Organization Name:NATIVA WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:HENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:AVITAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-951-7200
Mailing Address - Street 1:10030 CARA ST
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608-7117
Mailing Address - Country:US
Mailing Address - Phone:201-951-7200
Mailing Address - Fax:
Practice Address - Street 1:10030 CARA ST
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-7117
Practice Address - Country:US
Practice Address - Phone:201-951-7200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WI0500XNursing Service ProvidersRegistered NurseInfusion TherapyGroup - Single Specialty