Organization Active NPI

Vip Woundcare Inc Dba Azalea Wellness

  • Adult Medicine Physician
  • Minneola, FL
National Provider Identifier
1245112663
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
VIP WOUNDCARE INC DBA AZALEA WELLNESS
Practice address
1600 Evening Summit Cir
Minneola, FL 34715-9104
Phone
(678) 468-3856
NPI assigned
Jul 24, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shelia Moore Faine, NURSE PRACTITIONER
Title
Owner
Phone
(678) 468-3856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

1600 Evening Summit Cir
Minneola, FL 34715-9104

Mailing address

1683 N Hancock Rd Ste 103-132
Minneola, FL 34715-8189
Phone (678) 468-3856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250930001474 FL Part B Supplier - Clinic/Group Practice 3870099807 Receives reassigned benefits from 1 practitioner
Practice locations: Minneola, FL

National Provider Directory

National Provider Directory

Locations

1683 N Hancock Rd
Ste 103132
Minneola, FL 34715

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1245112663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1683 N HANCOCK RD STE 103-132",
            "city": "MINNEOLA",
            "state": "FL",
            "postal_code": "347158189",
            "telephone_number": "678-468-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 EVENING SUMMIT CIR",
            "city": "MINNEOLA",
            "state": "FL",
            "postal_code": "347159104",
            "telephone_number": "678-468-3856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP WOUNDCARE INC DBA AZALEA WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A",
        "authorized_official_last_name": "FAINE",
        "authorized_official_first_name": "SHELIA",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-468-3856",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.