Provider Demographics
NPI:1992022560
Name:THE BILTMORE GROUP LLC
Entity Type:Organization
Organization Name:THE BILTMORE GROUP LLC
Other - Org Name:PHYSICIANS WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THADDEUS
Authorized Official - Last Name:LEGOWIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:407-518-1041
Mailing Address - Street 1:445 W OAK ST
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-6627
Mailing Address - Country:US
Mailing Address - Phone:407-518-1041
Mailing Address - Fax:407-518-1042
Practice Address - Street 1:445 W OAK ST
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-6627
Practice Address - Country:US
Practice Address - Phone:407-518-1041
Practice Address - Fax:407-518-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-22
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME25156208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty