Organization
ADVANCED WELLNESS INFUSION CENTERS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY LEANN ALLMAN (PRACTICE ADMINISTRATOR)
(352) 702-0850
Entity
Organization
Contact information
Practice address
202 SW 17TH ST STE B, OCALA, FL 34471-8138
(352) 353-0055
(352) 443-5768
Mailing address
616 N PALMETTO ST, LEESBURG, FL 34748-4417
(352) 702-0850
(352) 530-2476
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
208M00000X
Hospitalist Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407893571
INDIVIDUAL NPI
FL
01
—
1932199197
INDIVIDUAL NPI
FL
Enumeration date
09/28/2023
Last updated
09/28/2023
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