Provider Demographics
NPI:1457814402
Name:DOCTORS FOR WELLNESS LLC
Entity Type:Organization
Organization Name:DOCTORS FOR WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARBINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:GHULLDU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-370-9783
Mailing Address - Street 1:6900 TURKEY LAKE RD STE 1-1
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-4707
Mailing Address - Country:US
Mailing Address - Phone:407-370-9783
Mailing Address - Fax:407-370-9784
Practice Address - Street 1:6900 TURKEY LAKE RD STE 1-1
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-4707
Practice Address - Country:US
Practice Address - Phone:407-370-9783
Practice Address - Fax:407-370-9784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty