| C3 Wellness Spa | |
|
395 Village Dr Kissimmee FL 34759-4012 | |
| (407) 914-9168 | |
| (407) 337-8005 |
| Full Name | C3 Wellness Spa |
|---|---|
| Speciality | Clinic/Center |
| Location | 395 Village Dr, Kissimmee, Florida |
| Authorized Official Name and Position | Crystal Bethea (OWNER) |
| Authorized Official Contact | 4078378685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C3 Wellness Spa 2717 Eagle Canyon Dr S Kissimmee FL 34746-3170 Ph: (407) 914-9168 | C3 Wellness Spa 395 Village Dr Kissimmee FL 34759-4012 Ph: (407) 914-9168 |
| NPI Number | 1811490287 |
|---|---|
| Provider Enumeration Date | 03/13/2018 |
| Last Update Date | 05/28/2026 |
| Certification Date | 05/28/2026 |
| Medicare PECOS PAC ID | 1355605502 |
|---|---|
| Medicare Enrollment ID | O20190806000105 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811490287 | NPI | - | NPPES |
| 113572200 | Medicaid | FL | |
| 024831500 | Medicaid | FL | |
| 112243500 | Medicaid | FL |
| Provider Name | Christopher M Varnum |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1760459200 PECOS PAC ID: 1850368655 Enrollment ID: I20040913000151 |
| Provider Name | Ehrentraud J Eichelbaum |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1255518486 PECOS PAC ID: 3779700836 Enrollment ID: I20140813001547 |
| Provider Name | Jose E Rivas |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1952588188 PECOS PAC ID: 4284958562 Enrollment ID: I20150114001633 |
| Provider Name | Aida Hechavarria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225409410 PECOS PAC ID: 0143513655 Enrollment ID: I20160721000530 |
| Provider Name | Jose Rudy Vargas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487809463 PECOS PAC ID: 0345485611 Enrollment ID: I20200624000512 |
| Provider Name | Elijah Nahova Stewart |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1295511525 PECOS PAC ID: 6103270699 Enrollment ID: I20231003001021 |
| Provider Name | Brooke Emily Jacobs |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1659041358 PECOS PAC ID: 7810430444 Enrollment ID: I20240624001315 |
| Provider Name | Elida a Rocha Arroyo |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437984515 PECOS PAC ID: 1557892015 Enrollment ID: I20241008002449 |
| Provider Name | Kenneth J Guidera |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922150697 PECOS PAC ID: 2567880628 Enrollment ID: I20250417002998 |
| Provider Name | James Giles |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952192650 PECOS PAC ID: 9436678117 Enrollment ID: I20250527001153 |
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