Provider Demographics
NPI:1194314591
Name:ALLERGY & FAMILY WELLNESS CLINIC
Entity type:Organization
Organization Name:ALLERGY & FAMILY WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAYEED
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:305-343-3317
Mailing Address - Street 1:2601 PALISADE BLVD
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-7862
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10960 DYLAN LOREN CIR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32825-4439
Practice Address - Country:US
Practice Address - Phone:407-734-1242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-11
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty