| Well Space, Llc | |
|
3606 14th St Sw Lehigh Acres FL 33976-2949 | |
| (239) 788-4485 | |
| Not Available |
| Full Name | Well Space, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 3606 14th St Sw, Lehigh Acres, Florida |
| Authorized Official Name and Position | Katia Jasmin Robinson Lucero (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 2397884485 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Well Space, Llc 3606 14th St Sw Lehigh Acres FL 33976-2949 Ph: (239) 788-4485 | Well Space, Llc 3606 14th St Sw Lehigh Acres FL 33976-2949 Ph: (239) 788-4485 |
| NPI Number | 1366030934 |
|---|---|
| Provider Enumeration Date | 01/08/2021 |
| Last Update Date | 04/08/2025 |
| Certification Date | 04/08/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366030934 | NPI | - | NPPES |
| 018998800 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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