Provider Demographics
NPI:1154296267
Name:FLO MED SPA AND WELLNESS
Entity type:Organization
Organization Name:FLO MED SPA AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TRIVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-500-3969
Mailing Address - Street 1:111 KILSON DR STE 103
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8218
Mailing Address - Country:US
Mailing Address - Phone:704-500-0945
Mailing Address - Fax:704-885-0591
Practice Address - Street 1:111 KILSON DR STE 300
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8217
Practice Address - Country:US
Practice Address - Phone:704-500-0945
Practice Address - Fax:704-885-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-08
Last Update Date:2025-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty