Organization
MEDICAL WELLNESS INSTITUTE OF AMERICA INC
Active
Organization
MEDICAL WELLNESS INSTITUTE OF AMERICA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MARK FANNIN MD (PRESIDENT)
(850) 932-5767
Entity
Organization
Contact information
Practice address
3575 GULF BREEZE PKWY, GULF BREEZE, FL 32563-3407
(850) 932-5767
(850) 932-5774
Mailing address
3575 GULF BREEZE PKWY, GULF BREEZE, FL 32563-3407
(850) 932-5767
(850) 932-5774
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME96388
FL
Other
Enumeration date
12/07/2011
Last updated
12/09/2011
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