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Organization
SOUTHERN MAGNOLIA HEALTH AND WELLNESS LLC
Active
Organization
SOUTHERN MAGNOLIA HEALTH AND WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOPE A KING APRN (OWNER/APRN)
(407) 590-0377
Entity
Organization
Contact information
Practice address
533 N NOVA RD STE 209, ORMOND BEACH, FL 32174-4422
(407) 590-0377
Mailing address
490 N YONGE ST, ORMOND BEACH, FL 32174-5252
(407) 590-0377
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/11/2020
Last updated
09/11/2020
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