Organization
EXTREME INFUSED MEDICAL PLUS
Active
Other names
Coast to Coast Family Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
NIKALINA LELIEA DUNDAS APRN FNP C (OWNER PROVIDER)
(352) 220-3873
Entity
Organization
Contact information
Practice address
11871 ILLINOIS ST, DUNNELLON, FL 34431-6503
(352) 220-3873
(352) 517-7088
Mailing address
11871 ILLINOIS ST, DUNNELLON, FL 34431-6503
(352) 220-3873
(352) 517-7088
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HUR18
BCBS
FL
Enumeration date
07/21/2022
Last updated
09/02/2025
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