# AGELESS REWIND LLC

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

## Provider details

- **NPI number:** 1851126932
- **Authorized official:** KELLI WRAZIEN AGNP (OWNER/CEO)
- **Authorized official phone:** (813) 460-6440

## Contact information

- **Practice address:** 1911 BLUE RIVER RD, HOLIDAY, FL 34691-7849
- **Practice address phone:** (727) 320-7313
- **Mailing address:** 1911 BLUE RIVER RD, HOLIDAY, FL 34691-7849
- **Mailing address phone:** (813) 360-1806

## Taxonomy

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

## Other

- **Enumeration date:** 09/06/2024
- **Last updated:** 03/13/2025