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Organization
MW WELLNESS XIII
Active
Organization
MW WELLNESS XIII
Active
Other names
Medi Weightloss
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE ILENE BALKCOM RN (OWNER)
(727) 953-3599
Entity
Organization
Contact information
Practice address
26236 US HIGHWAY 19 N, CLEARWATER, FL 33761-3580
(727) 953-3599
(727) 953-3608
Mailing address
26236 US HIGHWAY 19 N, CLEARWATER, FL 33761-3580
(727) 953-3599
(727) 953-3608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/25/2025
Last updated
02/25/2025
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