Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Intentionally Well, LLC

Organization Family Medicine Physician · NPI 1922426402

Intentionally Well, LLC is a Family Medicine Physician in Port St Lucie, Florida. Works from 2 locations. Licensed in Florida.

Licensed in
FL
In the registry since
2014
Specialties on file
2
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2100 SE Hillmoor Dr Ste 101
Port St Lucie, FL 34952-8057
Phone: (772) 877-2311
Fax: (772) 249-0638
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3716 Sw Moore St, Palm City, FL 34990-5647 — (772) 215-9946

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1476272 (FL)
Family Medicine Physician Taxonomy 207Q00000X · Licence ME69414 (FL)

Record details

NPI number1922426402
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theresa Pinder — Sole Member, Ceo · (772) 215-9946
NPI enumeratedApril 2, 2014
Last updated in NPPESJuly 19, 2024
Certification dateJuly 19, 2024
Mailing address2100 Se Hillmoor Dr Ste 101, Port St Lucie, FL 34952-8057

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