Provider Demographics
NPI:1962730283
Name:DOCTORS WELLNESS CENTER
Entity type:Organization
Organization Name:DOCTORS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:LINKOUS
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:727-398-8800
Mailing Address - Street 1:13133 66TH ST
Mailing Address - Street 2:UNIT204
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33773-1812
Mailing Address - Country:US
Mailing Address - Phone:727-398-8800
Mailing Address - Fax:727-398-8811
Practice Address - Street 1:13133 66TH ST
Practice Address - Street 2:UNIT204
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33773-1812
Practice Address - Country:US
Practice Address - Phone:727-398-8800
Practice Address - Fax:727-398-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-24
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS91462081N0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081N0008XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationNeuromuscular MedicineGroup - Single Specialty