| Illusions Wellness And Recovery Llc | |
|
800 Viginia Ave Ste 59 B Fort Pierce FL 34982 | |
| (772) 577-6323 | |
| Not Available |
| Full Name | Illusions Wellness And Recovery Llc |
|---|---|
| Speciality | Registered Nurse |
| Location | 800 Viginia Ave, Fort Pierce, Florida |
| Authorized Official Name and Position | Nydia M Whitaker (OWNER) |
| Authorized Official Contact | 7235776323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Illusions Wellness And Recovery Llc 800 Viginia Ave Ste 59 B Fort Pierce FL 34982 Ph: (772) 577-6323 | Illusions Wellness And Recovery Llc 800 Viginia Ave Ste 59 B Fort Pierce FL 34982 Ph: (772) 577-6323 |
| NPI Number | 1518798214 |
|---|---|
| Provider Enumeration Date | 08/13/2024 |
| Last Update Date | 08/26/2024 |
| Medicare PECOS PAC ID | 9234666041 |
|---|---|
| Medicare Enrollment ID | O20241218000724 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518798214 | NPI | - | NPPES |
| Provider Name | Nydia M Whitaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639461023 PECOS PAC ID: 2062949878 Enrollment ID: I20241218001058 |
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