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Intentionally Well, Llc
Family Nurse Practitioner in Port St Lucie, Florida
NPI 1922426402

Intentionally Well, Llc is a Family Nurse Practitioner based in Port St Lucie, FL and is specialized in Family. Intentionally Well, Llc practices in Port St Lucie, FL. The NPI Number for Intentionally Well, Llc is 1922426402 and holds a License No. ME69414 (Florida).

The current practice location address for Intentionally Well, Llc is 2100 Se Hillmoor Dr Ste 101, Port St Lucie, FL and can be reached out via phone at 772-877-2311 and via fax at 772-249-0638.

Location: 2100 Se Hillmoor Dr Ste 101, Port St Lucie, FL, 34952-8057
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1922426402
Provider Name
Intentionally Well, Llc
Credential
Provider Entity Type
Organization
Address
2100 Se Hillmoor Dr Ste 101, Port St Lucie, FL, 34952-8057
Phone Number
772-877-2311
Fax Number
772-249-0638
Provider Enumeration Date
04/02/2014
Last Update Date
08/17/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1912256538 01 NPI
institution
Provider Business Practice Location Address Details
Address
2100 Se Hillmoor Dr Ste 101
City
Port St Lucie
State
Florida
Zip
34952-8057
Phone Number
772-877-2311
Fax Number
772-249-0638
person
Provider Business Mailing Address Details
Address
2100 Se Hillmoor Dr Ste 101
City
Port St Lucie
State
Florida
Zip
34952-8057
Phone Number
772-877-2311
Fax Number
772-249-0638
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
1476272 (Florida)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
ME69414 (Florida)
Definition
Definition to come...
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