Provider Demographics
NPI:1447056262
Name:BE WELL FAMILY CARE LLC
Entity type:Organization
Organization Name:BE WELL FAMILY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKE
Authorized Official - Suffix:
Authorized Official - Credentials:ARPN
Authorized Official - Phone:321-486-7654
Mailing Address - Street 1:4217 S HOPKINS AVE
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32780-6605
Mailing Address - Country:US
Mailing Address - Phone:321-486-7654
Mailing Address - Fax:
Practice Address - Street 1:4217 S HOPKINS AVE
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-6605
Practice Address - Country:US
Practice Address - Phone:321-486-7654
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care