Basic Information
| Provider Information | |||||||||
| NPI: | 1629460142 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WELLSRPING HEALTH OF FLORIDA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300 WINDY RIDGE PKWY SE | ||||||||
| Address2: | #210 SOUTH | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303395665 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788130505 | ||||||||
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| Practice Location | |||||||||
| Address1: | 150 W UNIVERSITY BLVD | ||||||||
| Address2: | FLORIDA INSTITUTE OF TECHNOLOGY | ||||||||
| City: | MELBOURNE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329016982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788130505 | ||||||||
| FaxNumber: | 6788130505 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/20/2015 | ||||||||
| LastUpdateDate: | 09/08/2017 | ||||||||
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| AuthorizedOfficialLastName: | TOWNSEND | ||||||||
| AuthorizedOfficialFirstName: | DEBRA | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP OF RCM | ||||||||
| AuthorizedOfficialTelephone: | 4704401647 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | RIVERMEND HEALTH | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QC1500X | HCC10390 | FL | Y | Ambulatory Health Care Facilities | Clinic/Center | Community Health |
No ID Information.