Provider Demographics
NPI:1871151886
Name:WELLNESS ON DEMAND LLC
Entity type:Organization
Organization Name:WELLNESS ON DEMAND LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VERONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:TROLLERUD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:306-546-0872
Mailing Address - Street 1:430 S DIXIE HWY STE 207
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2200
Mailing Address - Country:US
Mailing Address - Phone:786-360-4440
Mailing Address - Fax:
Practice Address - Street 1:430 S DIXIE HWY STE 207
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2200
Practice Address - Country:US
Practice Address - Phone:786-360-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion Therapy