# IASO MIND & WELLNESS LLC

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

## Provider details

- **NPI number:** 1316881931
- **Authorized official:** ANGELA ROSE WHITTAMORE PMHNP (PMHNP/OWNER)
- **Authorized official phone:** (321) 747-4331

## Contact information

- **Practice address:** 4640 LIPSCOMB ST NE STE 13, PALM BAY, FL 32905-2986
- **Practice address phone:** (321) 223-0143
- **Practice address fax:** (689) 444-5626
- **Mailing address:** 491 FELLENZ ST SW, PALM BAY, FL 32908-4785
- **Mailing address phone:** (321) 223-0143

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/15/2026
- **Last updated:** 04/15/2026