Organization
PENTUS HEALTTH WABASH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IVAN REYES (ADMINISTRATOR)
(352) 304-4109
Entity
Organization
Contact information
Practice address
111 N WABASH AVE STE 620, CHICAGO, IL 60602-1914
(352) 304-4109
Mailing address
2273 LEE RD STE 101, WINTER PARK, FL 32789-7213
(352) 304-4109
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/26/2025
Last updated
03/26/2025
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