Organization
DIVINE DESTINY VIRTUAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUELLA PRITCHETTE DO (OWNER)
(407) 732-0720
Entity
Organization
Contact information
Practice address
2631A NW 41ST ST, GAINESVILLE, FL 32606-6628
(407) 732-2070
Mailing address
2631A NW 41ST ST, GAINESVILLE, FL 32606-6628
(407) 732-0720
(855) 604-0918
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104161017
COMMERCIAL
FL
01
—
1104161017
COMMERCIAL
PA
05
—
1104161017
—
FL
05
—
1104161017
—
PA
Enumeration date
07/06/2020
Last updated
11/27/2023
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