| Impact Therapy & Wellness LLC | |
|
131 Hotel Ave Edgewater FL 32132-2362 | |
| (954) 560-0782 | |
| Not Available |
| Full Name | Impact Therapy & Wellness LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 131 Hotel Ave, Edgewater, Florida |
| Authorized Official Name and Position | Victoria Hill (CEO) |
| Authorized Official Contact | 9545600782 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Impact Therapy & Wellness LLC 131 Hotel Ave Edgewater FL 32132-2362 | Impact Therapy & Wellness LLC 131 Hotel Ave Edgewater FL 32132-2362 Ph: (954) 560-0782 |
| NPI Number | 1013890128 |
|---|---|
| Provider Enumeration Date | 07/28/2025 |
| Last Update Date | 07/28/2025 |
| Certification Date | 07/28/2025 |
| Medicare PECOS PAC ID | 1456846021 |
|---|---|
| Medicare Enrollment ID | O20251219004058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013890128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Victoria Esham |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508678624 PECOS PAC ID: 2365937935 Enrollment ID: I20251230002283 |
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