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Organization
MW WELLNESS XIII
Active
Organization
MW WELLNESS XIII
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ILENE BALKCOM (OWNER/ OPERATOR)
(727) 420-6986
Entity
Organization
Contact information
Practice address
2445 COUNTRY PLACE BLVD, NEW PORT RICHEY, FL 34655-1102
(727) 420-6986
Mailing address
2445 COUNTRY PLACE BLVD STE 101, NEW PORT RICHEY, FL 34655-1102
(727) 420-6986
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/01/2025
Last updated
03/05/2026
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