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Organization
BODY ENVI WEIGHT LOSS & WELLNESS II
Active
Organization
BODY ENVI WEIGHT LOSS & WELLNESS II
Active
Parent organization
PMC KNEE PAIN & RESTORATION LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PMC KNEE PAIN & RESTORATION LLC
Authorized official
ASHLEY MORERA (CEO)
(813) 888-7710
Entity
Organization
Contact information
Practice address
6904 W LINEBAUGH AVE, TAMPA, FL 33625
(813) 888-7710
(813) 908-7711
Mailing address
13449 CANOPY CREEK DR, TAMPA, FL 33625-5915
(813) 888-7710
(813) 908-7711
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
—
NULL
2083X0100X
Occupational Medicine Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/08/2018
Last updated
06/18/2018
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