Provider Demographics
NPI:1568236057
Name:THRYVE FLORIDA HEALTH AND WELLNESS
Entity Type:Organization
Organization Name:THRYVE FLORIDA HEALTH AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:646-314-3503
Mailing Address - Street 1:1230 OAKLEY SEAVER DR
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711-1961
Mailing Address - Country:US
Mailing Address - Phone:407-274-9322
Mailing Address - Fax:407-274-9907
Practice Address - Street 1:1230 OAKLEY SEAVER DR
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-1961
Practice Address - Country:US
Practice Address - Phone:407-274-9322
Practice Address - Fax:407-274-9907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care