# BEYOND THE BODY WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194473751
- **Authorized official:** MRS. DEDRA D COOP NP (NP/PRESIDENT)
- **Authorized official phone:** (765) 432-7195

## Contact information

- **Practice address:** 1121 HOMESTEAD RD N STE 279, LEHIGH ACRES, FL 33936-6038
- **Practice address phone:** (765) 432-7195
- **Mailing address:** 1121 HOMESTEAD RD N STE 279, LEHIGH ACRES, FL 33936-6038
- **Mailing address phone:** (765) 432-7195

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/14/2022
- **Last updated:** 03/14/2022