Provider Demographics
NPI:1487778254
Name:JADE TREE WELLNESS CENTER, INC.
Entity type:Organization
Organization Name:JADE TREE WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:ELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:AP, LMT
Authorized Official - Phone:727-344-8690
Mailing Address - Street 1:6701 38TH AVE N
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1542
Mailing Address - Country:US
Mailing Address - Phone:727-344-8690
Mailing Address - Fax:727-381-9390
Practice Address - Street 1:6701 38TH AVE N
Practice Address - Street 2:SUITE 3
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1542
Practice Address - Country:US
Practice Address - Phone:727-344-8690
Practice Address - Fax:727-381-9390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1475171100000X
FLMA16588246ZA2600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered246ZA2600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherArt, MedicalGroup - Multi-Specialty