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Contact Information

ADVANCED WELLNESS & SPORTS REHAB, LLC
14028 5TH ST
DADE CITY, FL33525
 Phone: 352-600-2232
 Fax: 352-292-0136
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for ADVANCED WELLNESS & SPORTS REHAB, LLC

NPI # 1134481005
LBN Legal business name ADVANCED WELLNESS & SPORTS REHAB, LLC
Authorized official PHILIP SNYDER - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/15/2012
Last updated 02/12/2019 - About 7 years ago
Identifiers
FL License # CH10458
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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