Provider Demographics
NPI:1306227988
Name:ASANA WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:ASANA WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:800-332-7262
Mailing Address - Street 1:201 N KROME AVE
Mailing Address - Street 2:SUITE # 210
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33030-6010
Mailing Address - Country:US
Mailing Address - Phone:305-246-0056
Mailing Address - Fax:305-246-0093
Practice Address - Street 1:9119 MERRILL RD
Practice Address - Street 2:SUITE # 32
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-4312
Practice Address - Country:US
Practice Address - Phone:800-332-7262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-09
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Multi-Specialty