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Organization

ADVANCED PRACTICE AND WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY WADE PRINCE (CO-OWNER)
(256) 612-0173
Entity
Organization

Contact information

Practice address
2425 S VOLUSIA AVE STE B3, ORANGE CITY, FL 32763-7625
(386) 473-7005
(386) 473-7006
Mailing address
2425 S VOLUSIA AVE STE B3, ORANGE CITY, FL 32763-7625
(386) 473-7005
(386) 473-7006

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
207Q00000X
Family Medicine Physician
Primary
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
05/29/2024
Last updated
10/29/2025
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