| Amandla Wellness Center, Llc | |
|
850 S 21st St Ste M Fort Pierce FL 34950-4846 | |
| (772) 708-0273 | |
| (866) 519-0540 |
| Full Name | Amandla Wellness Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 850 S 21st St Ste M, Fort Pierce, Florida |
| Authorized Official Name and Position | Margaret Lott (CEO/FOUNDER) |
| Authorized Official Contact | 7727080273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amandla Wellness Center, Llc 850 S 21st St Ste M Fort Pierce FL 34950-4846 Ph: (772) 708-0273 | Amandla Wellness Center, Llc 850 S 21st St Ste M Fort Pierce FL 34950-4846 Ph: (772) 708-0273 |
| NPI Number | 1144037532 |
|---|---|
| Provider Enumeration Date | 12/18/2024 |
| Last Update Date | 12/18/2024 |
| Medicare PECOS PAC ID | 3173052693 |
|---|---|
| Medicare Enrollment ID | O20250129002029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144037532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Margaret P Lott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356735393 PECOS PAC ID: 7113252008 Enrollment ID: I20190715002798 |
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