Provider Demographics
NPI:1275291163
Name:ADEPT HEALTH & WELLNESS
Entity Type:Organization
Organization Name:ADEPT HEALTH & WELLNESS
Other - Org Name:ADEPT HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/CMO/COO
Authorized Official - Prefix:DR
Authorized Official - First Name:DELPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTCHA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-692-6981
Mailing Address - Street 1:10536 CORY LAKE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:945 E BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5500
Practice Address - Country:US
Practice Address - Phone:813-692-6981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center