Provider Demographics
NPI:1912718982
Name:TOTALWELL HEALTH CLINIC PLLC
Entity type:Organization
Organization Name:TOTALWELL HEALTH CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/ CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-257-9947
Mailing Address - Street 1:1425 TUSKAWILLA RD STE 221
Mailing Address - Street 2:
Mailing Address - City:WINTER SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32708-5289
Mailing Address - Country:US
Mailing Address - Phone:910-257-9947
Mailing Address - Fax:
Practice Address - Street 1:1425 TUSKAWILLA RD STE 221
Practice Address - Street 2:
Practice Address - City:WINTER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32708-5289
Practice Address - Country:US
Practice Address - Phone:910-257-9947
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1851555759Medicaid
FL1760442834OtherNPI NUMBER DR. JOSEPH JOHNSON
FL1851555759OtherNPI NUMBER DR. HEIDY ORMENO LOPEZ
FLME109010OtherFLORIDA MEDICAL LICENSE DR. HEIDY ORMENO
FL1760442834Medicaid
FLME144087OtherFLORIDA MEDICAL LICENSE
IN01054071AOtherINDIANA MEDICAL LICENSE
GA65445OtherGEORGIA MEDICAL LICENSE