Provider Demographics
NPI:1972175529
Name:NUVO WELLNESS & RECOVERY LLC
Entity Type:Organization
Organization Name:NUVO WELLNESS & RECOVERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DJUNOT
Authorized Official - Middle Name:
Authorized Official - Last Name:DESTINA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-914-3381
Mailing Address - Street 1:1400 N HWY A1A STE 105
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-2736
Mailing Address - Country:US
Mailing Address - Phone:321-914-3381
Mailing Address - Fax:
Practice Address - Street 1:1400 N HWY A1A STE 105
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-2736
Practice Address - Country:US
Practice Address - Phone:321-914-3381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty