Organization
SOULPHYSIO WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANEESH CHAUDHRY (OWNER)
(937) 768-8347
Entity
Organization
Contact information
Practice address
12977 GABOR AVE, ORLANDO, FL 32827-3869
(937) 768-8347
Mailing address
988 BLVD OF THE ARTS APT 1914, SARASOTA, FL 34236-4851
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
03/25/2022
Last updated
04/13/2022
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