Organization · NPI-2

Ethica Wellcare Technologies LLC

Nurse Practitioner, Primary Care · Orlando, FL

NPI number1073253746

StatusActive

Last updated in NPPESApr 20, 2022

Details

NPI: 1073253746
Entity type: Organization (NPI-2)
Legal business name: Ethica Wellcare Technologies LLC
Organization subpart: Yes
Enumeration date: Mar 31, 2022
Certification date: Apr 20, 2022
Last updated: Apr 20, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
363LP2300X	Nurse Practitioner, Primary Care	–	–	Yes
163W00000X	Registered Nurse	–	–
163WG0000X	Registered Nurse, General Practice	–	–
163WH0200X	Registered Nurse, Home Health	–	–
174400000X	Specialist	–	–
208D00000X	General Practice	–	–
305S00000X	Point of Service	–	–
363A00000X	Physician Assistant	–	–
363AM0700X	Physician Assistant, Medical	–	–
363L00000X	Nurse Practitioner	–	–
363LF0000X	Nurse Practitioner, Family	–	–
363LP0808X	Nurse Practitioner, Psych/Mental Health	–	–
364SH0200X	Clinical Nurse Specialist, Home Health	–	–

Other names

Ethica Wellcare (Doing Business As)
Modifyu (Doing Business As)

Practice location

450 S Orange Ave
Orlando, FL 32801-3383

Phone 407-930-9551

Mailing address

450 S Orange Ave
Orlando, FL 32801-3383

Phone 407-930-9551

Authorized official

Erica Vallee
Director
6199976053

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