National Provider Identifier Database

AGELESS REWIND LLC
Primary Care


Contact Information

AGELESS REWIND LLC
1911 BLUE RIVER RD
HOLIDAY, FL34691-7849
Phone: 727-320-7313
Fax:
Website:
Specialty Taxonomy Code
* Primary Care 363LP2300X

* Indicates primary specialty

NPI Profile & details for AGELESS REWIND LLC

NPI Number 1851126932
Legal business name
LBN
AGELESS REWIND LLC
Authorized official KELLI WRAZIEN - (OWNER/CEO)
Entity Organization
Organization subpart No
Enumeration date 09/06/2024
Last updated 03/13/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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