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Contact Information

INTERNAL MEDICINE & PEDIATRICS WELLNESS CENTER
6038 W. NORDLING LOOP
CRYSTAL RIVER, FL34429
 Phone: 352-795-2459
 Fax: 352-795-4322
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for INTERNAL MEDICINE & PEDIATRICS WELLNESS CENTER

NPI Number 1992825145
LBN Legal business name INTERNAL MEDICINE & PEDIATRICS WELLNESS CENTER
Authorized official CARLENE WILSON - (OWNER/PHYSICIAN)
Entity Organization
Organization subpart 1 No
Enumeration date 03/30/2007
Last updated 06/05/2014 - About 12 years ago
Identifiers
FL License # ME93743
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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