Provider Demographics
NPI:1619248275
Name:TAVERNIER WELLNESS CENTER, INC
Entity Type:Organization
Organization Name:TAVERNIER WELLNESS CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:H
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, LMT
Authorized Official - Phone:305-394-0668
Mailing Address - Street 1:101 OCEAN LN
Mailing Address - Street 2:
Mailing Address - City:ISLAMORADA
Mailing Address - State:FL
Mailing Address - Zip Code:33036-3913
Mailing Address - Country:US
Mailing Address - Phone:305-394-0668
Mailing Address - Fax:
Practice Address - Street 1:82913 OVERSEAS HWY
Practice Address - Street 2:
Practice Address - City:ISLAMORADA
Practice Address - State:FL
Practice Address - Zip Code:33036-3638
Practice Address - Country:US
Practice Address - Phone:305-394-0668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-13
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty