Organization
WELLNESS FIRM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT SUPERNOR (OWNER)
(727) 410-4828
Entity
Organization
Contact information
Practice address
29817 US HIGHWAY 19 N, CLEARWATER, FL 33761-1527
(727) 431-6869
Mailing address
12191 W LINEBAUGH AVE # 624, TAMPA, FL 33626-1732
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/02/2022
Last updated
02/08/2022
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