Abundant Life Institute, LLC
Family Medicine in Tallahassee, FL. Organization (NPI-2).
NPI number1407505431
StatusActive
Last updated in NPPESJan 7, 2023
Details
- NPI
- 1407505431
- Entity type
- Organization (NPI-2)
- Legal business name
- Abundant Life Institute, LLC
- Organization subpart
- No
- Enumeration date
- Mar 18, 2022
- Certification date
- Jan 7, 2023
- Last updated
- Jan 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
Other names
- Abundant Life Institute (Doing Business As)
Practice location
2646 Centennial Pl Ste ATallahassee, FL 32308-0573
Phone 850-402-6210
Mailing address
2646 Centennial Pl Ste ATallahassee, FL 32308-0573
Authorized official
Brandy C Willis
Owner
8507020300
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