Organization
MENOVATIONS WELLNESS LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN SIMUEL BEASLEY III NP (MEMBER)
(813) 474-7122
Entity
Organization
Contact information
Practice address
1101 E CUMBERLAND AVE STE 201H, TAMPA, FL 33602-4231
(813) 938-6615
Mailing address
1963 WESTOVER LN NW, KENNESAW, GA 30152-4254
(404) 990-2238
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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