OrganizationIdeal Health And Wellness Center LlcGeneral PracticeAllopathic & Osteopathic PhysiciansPractice Address8001 N Dale Mabry Hwy Bldg 301, Tampa, FL 33614-3290(813) 933-1511PECOS EnrollmentBased on the most recent information from CMS, provider Ideal Health And Wellness Center Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1235587676Provider TypeOrganizationFull NameIdeal Health And Wellness Center LlcSubpartNoEnumeration Date5/26/2016Last Updated5/26/2016Contact InformationPractice LocationPractice Address8001 N Dale Mabry Hwy Bldg 301, Tampa, FL 33614-3290Phone(813) 933-1511FaxUnlisted FaxMailing LocationMailing Address8001 N Dale Mabry Hwy Bldg 301, Tampa, FL 33614-3290Phone(813) 933-1511FaxUnlisted FaxAuthorized OfficialNameMaddox, Donna M (Owner)Phone(813) 933-1511Provider TaxonomiesCodeDescriptionLicenseCode208D00000XPrimaryDescriptionGeneral PracticeAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerCode111N00000XDescriptionChiropractorChiropractic ProvidersLicenseUnlisted Issuer