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INTENTIONALLY WELL, LLC
NPI 1922426402
Nurse Practitioner - Family in Port St Lucie, FL

Active since April 02, 2014
2100 SE HILLMOOR DR STE 101, PORT ST LUCIE, FL 34952(772) 877-2311(772) 249-0638 Get Directions Write a Review

NPPES record last updated: July 19, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Intentionally Well, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTENTIONALLY WELL, LLC (NPI 1922426402) is a healthcare organization registered as a family in Port St Lucie, Florida and active in the NPI registry since April 2014. The organization maintains a secondary practice location in Palm City and lists Theresa Anne Pinder, Sole Member, Ceo, as its authorized official.

NPPES Registry Identity

NPI1922426402
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameINTENTIONALLY WELL, LLC
Location Address2100 SE HILLMOOR DR STE 101Port St Lucie, FL 34952-8057
Mailing Address2100 Se Hillmoor Dr Ste 101Port St Lucie, FL 34952-8057 · (772) 877-2311 · Fax (772) 249-0638
Phone(772) 877-2311
Fax(772) 249-0638
Organization SubpartNo
Authorized OfficialTheresa Anne PinderSole Member, Ceo · (772) 215-9946
Enumeration DateApril 2, 2014
Last NPPES UpdateJuly 19, 2024
NPPES CertifiedJuly 19, 2024
✔ NPI 1922426402 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · 1476272
Also ListedFamily MedicineTaxonomy 207Q00000X · License ME69414 (FL)
2100 SE HILLMOOR DR STE 101, Port St Lucie, FL 34952
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Secondary Practice Location 1

Location 13716 SW Moore StPalm City, FL 34990-5647 · Phone (772) 215-9946

Other Identifiers 1

Other1912256538Npi

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIANNON BEBBLE PA-C
Physician Assistant
2100 SE HILLMOOR DR STE 101
PORT ST LUCIE, FL 34952
St. Lucie County (561) 303-3011
JENNIFER M QADIR PA-C
Physician Assistant
2100 SE HILLMOOR DR STE 101
PORT ST LUCIE, FL 34952
St. Lucie County (561) 262-8785
MRS. ALEXANDRIA DOLORES ST ROSE ARNP
Nurse Practitioner (Adult Health)
2100 SE HILLMOOR DR STE 101
PORT ST LUCIE, FL 34952
St. Lucie County (561) 713-3772
COASTAL CARE AND WELLNESS PLLC
Physician Assistant
2100 SE HILLMOOR DR STE 101
PORT ST LUCIE, FL 34952
St. Lucie County (561) 262-8785

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Intentionally Well, LLC's NPI number?

The NPI number for Intentionally Well, LLC is 1922426402. It was assigned to this organization in the NPPES registry on April 2, 2014.

Where is Intentionally Well, LLC located?

Intentionally Well, LLC is located at 2100 SE Hillmoor Dr Ste 101, Port St Lucie, FL 34952. The listed phone number is (772) 877-2311.

What is Intentionally Well, LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Intentionally Well, LLC was last updated on July 19, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.