Provider Demographics
NPI:1770453961
Name:A NEW YOU BODY AND MIND WELLNESS
Entity type:Organization
Organization Name:A NEW YOU BODY AND MIND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:401-662-7740
Mailing Address - Street 1:9448 CHANNING HILL DR
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-0249
Mailing Address - Country:US
Mailing Address - Phone:401-662-7740
Mailing Address - Fax:401-340-1813
Practice Address - Street 1:330 S PINEAPPLE AVE STE 101
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34236-7041
Practice Address - Country:US
Practice Address - Phone:401-662-7740
Practice Address - Fax:401-340-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-11
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty