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Organization

ELEVATE PRIMARY CARE & WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. NELA F BALLESTEROS MOYANO MD (MEDICAL DIRECTOR)
(407) 310-3102
Entity
Organization

Contact information

Practice address
107 LAKE EMMA COVE DR, LAKE MARY, FL 32746-2508
(407) 310-3102
Mailing address
107 LAKE EMMA COVE DR, LAKE MARY, FL 32746-2508
(407) 310-3102

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary

Other

Enumeration date
07/11/2024
Last updated
07/15/2024
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