Provider Demographics
NPI:1235796590
Name:NEXT WELLNESS LLC
Entity Type:Organization
Organization Name:NEXT WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:WAI
Authorized Official - Last Name:LOC
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:215-584-3828
Mailing Address - Street 1:3555 SW CORPORATE PKWY
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-8152
Mailing Address - Country:US
Mailing Address - Phone:215-584-3828
Mailing Address - Fax:
Practice Address - Street 1:3555 SW CORPORATE PKWY
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-8152
Practice Address - Country:US
Practice Address - Phone:215-584-3828
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center