Organization
FAMILY WELLNESS CLINIC LLP
Active
Other names
Family Wellness Clinic and Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
KAYODE BALOGUN (CEO)
(862) 216-2617
Entity
Organization
Contact information
Practice address
7236 STATE ROAD 52 STE 13, HUDSON, FL 34667-6749
(727) 233-6084
Mailing address
7236 STATE ROAD 52 STE 13, HUDSON, FL 34667-6749
(727) 233-6084
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210079717
—
MO
Enumeration date
12/11/2021
Last updated
01/10/2025
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