Provider Demographics
NPI:1124993068
Name:LEGACY WELLNESS & PRIMARY CARE LLC
Entity type:Organization
Organization Name:LEGACY WELLNESS & PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:DR
Authorized Official - First Name:PIERRELA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEBRUN
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:561-246-7588
Mailing Address - Street 1:PO BOX 3436
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33424-3436
Mailing Address - Country:US
Mailing Address - Phone:561-421-0785
Mailing Address - Fax:562-359-4455
Practice Address - Street 1:8927 HYPOLUXO RD STE A41023
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-5262
Practice Address - Country:US
Practice Address - Phone:561-300-0135
Practice Address - Fax:562-359-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-09
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care