Organization
WELLNESS& REJUVINATION CENTRE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNIER LAUREDAN MD (PD)
(908) 265-6199
Entity
Organization
Contact information
Practice address
270 NW PEACOCK BLVD STE 114, PORT ST LUCIE, FL 34986-1602
(772) 600-1000
Mailing address
270 NW PEACOCK BLVD STE 114, PORT ST LUCIE, FL 34986-1602
(772) 600-1000
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME126942
DEPARTMENT OF HEALTH
FL
Enumeration date
03/24/2019
Last updated
03/24/2019
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