Organization
LIVEWELL PASSPORT OF FLORIDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE BRUCE SOWERS III (OWNER)
(804) 614-8619
Entity
Organization
Contact information
Practice address
22606 PANAMA CITY BEACH PKWY, INLET BEACH, FL 32413-1150
(804) 614-8619
(844) 777-1754
Mailing address
22606 PANAMA CITY BEACH PKWY, INLET BEACH, FL 32413-1150
(804) 614-8619
(844) 777-1754
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/17/2025
Last updated
07/18/2025
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