Provider Demographics
NPI:1669037156
Name:ALL CARE MEDICAL AND WELLNESS CENTER LLC
Entity type:Organization
Organization Name:ALL CARE MEDICAL AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-849-1309
Mailing Address - Street 1:PO BOX 592122
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32859-2122
Mailing Address - Country:US
Mailing Address - Phone:407-815-2525
Mailing Address - Fax:
Practice Address - Street 1:1800 W OAK RIDGE RD STE B
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-3962
Practice Address - Country:US
Practice Address - Phone:407-856-8898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center