| NPI | 1598487050 |
|---|---|
| Former Legal Business Name | FUNCTIONAL MEDICINE & HOLISTIC WELLNESS, LLC |
| Doing Business As | PRIMARY CARE & FUNCTIONAL MEDICINE CONSULTANTS, LLC |
| Entity Type | Organization |
| Authorized Contact | YESENIA RAMOS Nurse Practitioner 850-215-5830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SA2200X Clinical Nurse Specialist, Adult Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2023-02-17 |