Provider Demographics
NPI:1538289939
Name:WELLNESS HEALTH ASSOCIATES
Entity Type:Organization
Organization Name:WELLNESS HEALTH ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSIST OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEAN MICHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-855-1700
Mailing Address - Street 1:9521 S ORANGE BLOSSOM TRL STE 102
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32837-8323
Mailing Address - Country:US
Mailing Address - Phone:407-855-1700
Mailing Address - Fax:407-855-1714
Practice Address - Street 1:9521 S ORANGE BLOSSOM TRL STE 102
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-8323
Practice Address - Country:US
Practice Address - Phone:407-855-1700
Practice Address - Fax:407-855-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty