Provider Demographics
NPI:1447586219
Name:TOTAL WELLNESS CARE, LLC
Entity Type:Organization
Organization Name:TOTAL WELLNESS CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:AKUA
Authorized Official - Middle Name:DWAMENAA
Authorized Official - Last Name:WIREDU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-422-7707
Mailing Address - Street 1:817 E MICHIGAN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-4625
Mailing Address - Country:US
Mailing Address - Phone:407-422-7707
Mailing Address - Fax:407-422-7708
Practice Address - Street 1:817 E MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-4625
Practice Address - Country:US
Practice Address - Phone:407-422-7707
Practice Address - Fax:407-422-7708
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH9600111N00000X
FLOS9203207Q00000X
FLME99798207R00000X
FLMA53165225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty