Provider Demographics
NPI:1760136287
Name:ABOVE AND BEYOND HEALTH AND WELLNESS LLC
Entity Type:Organization
Organization Name:ABOVE AND BEYOND HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AO
Authorized Official - Prefix:
Authorized Official - First Name:AMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAANU-PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:352-209-4366
Mailing Address - Street 1:5201 SW 90TH LN
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34476-9576
Mailing Address - Country:US
Mailing Address - Phone:352-209-4366
Mailing Address - Fax:
Practice Address - Street 1:1111 NE 25TH AVE STE 104
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-5665
Practice Address - Country:US
Practice Address - Phone:352-209-4366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLAPRN9186000OtherLICENSE NUMBER
FL114476000Medicaid