Provider Demographics
NPI:1740618693
Name:MY WELLNESS 4 U
Entity Type:Organization
Organization Name:MY WELLNESS 4 U
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNERQ
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:YEARWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:352-504-7456
Mailing Address - Street 1:39204 TACOMA DR
Mailing Address - Street 2:
Mailing Address - City:LADY LAKE
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:39204 TACOMA DR
Practice Address - Street 2:
Practice Address - City:LADY LAKE
Practice Address - State:FL
Practice Address - Zip Code:32159-6006
Practice Address - Country:US
Practice Address - Phone:352-504-7456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-30
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104428261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care