Organization
CENTRAL FLORIDA WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN T SHORTLY (AUTH OFFICIAL)
(863) 559-3434
Entity
Organization
Contact information
Practice address
5559 E SR 44, WILDWOOD, FL 34785-8282
(407) 226-2993
(407) 226-2996
Mailing address
8081 TURKEY LAKE RD STE 650, ORLANDO, FL 32819-7321
(407) 226-2993
(407) 226-2996
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/02/2021
Last updated
11/02/2021
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