Organization
ALW ENTERPRISES, PA
Active
Other names
NAB Life Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VIRGINIA HAUSER (PRACTICE MANAGER)
(850) 252-4303
Entity
Organization
Contact information
Practice address
1001 COLLEGE BLVD W STE B1, NICEVILLE, FL 32578-1049
(850) 252-4303
(833) 963-2101
Mailing address
1001 COLLEGE BLVD W STE B1, NICEVILLE, FL 32578-1049
(850) 252-4303
(833) 963-2101
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114286879
DR. MICHAEL ADAM WEISBRUCH
FL
Enumeration date
06/19/2019
Last updated
04/17/2025
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