Provider Demographics
NPI:1760161954
Name:IELEVATE WELLNESS LLC
Entity Type:Organization
Organization Name:IELEVATE WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:THUC
Authorized Official - Middle Name:
Authorized Official - Last Name:TRAN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:407-928-2229
Mailing Address - Street 1:17410 FL-50
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34711
Mailing Address - Country:US
Mailing Address - Phone:352-708-3033
Mailing Address - Fax:
Practice Address - Street 1:17410 FL-50
Practice Address - Street 2:SUITE 130
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711
Practice Address - Country:US
Practice Address - Phone:352-708-3033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2023-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty