Organization
LIVING WELL WELLNESS CENTER
Active
Other names
Living Well Wellness Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EVAN NEPTUNE (MANAGER)
(407) 429-4111
Entity
Organization
Contact information
Practice address
3975 S ORANGE BLOSSOM TRL, SUITE 105, ORLANDO, FL 32839-7903
(407) 429-4111
Mailing address
3975 S ORANGE BLOSSOM TRL, SUITE 105, ORLANDO, FL 32839-7903
(407) 429-4111
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4111
—
FL
Enumeration date
09/27/2016
Last updated
09/27/2016
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