Provider Demographics
NPI:1780475012
Name:SELECT HEALTH AND WELLNESS LLC
Entity type:Organization
Organization Name:SELECT HEALTH AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JON PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:FRITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:905-425-9060
Mailing Address - Street 1:1845 EASTWEST PKWY STE 10-12
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-6405
Mailing Address - Country:US
Mailing Address - Phone:904-425-9060
Mailing Address - Fax:904-425-9060
Practice Address - Street 1:1845 EASTWEST PKWY STE 10-12
Practice Address - Street 2:
Practice Address - City:FLEMING ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32003-6405
Practice Address - Country:US
Practice Address - Phone:904-425-9060
Practice Address - Fax:904-425-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-15
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty