Provider Demographics
NPI:1316792070
Name:NAVIGATING WELLNESS PRIMARY CARE PLLC
Entity type:Organization
Organization Name:NAVIGATING WELLNESS PRIMARY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AND CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KORANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:CCA
Authorized Official - Phone:407-770-8160
Mailing Address - Street 1:543 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32779-2646
Mailing Address - Country:US
Mailing Address - Phone:407-770-8160
Mailing Address - Fax:877-284-1946
Practice Address - Street 1:50 COLUMBIA ST STE 11
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6331
Practice Address - Country:US
Practice Address - Phone:407-850-8199
Practice Address - Fax:877-284-1946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-17
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty