Provider Demographics
NPI:1063799914
Name:WONDERLAND WORLD HEALTH AGENCY INC.
Entity type:Organization
Organization Name:WONDERLAND WORLD HEALTH AGENCY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:JUNET
Authorized Official - Last Name:VASALLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-548-8089
Mailing Address - Street 1:5055 NW 7TH ST APT 609
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33126-3424
Mailing Address - Country:US
Mailing Address - Phone:786-548-8089
Mailing Address - Fax:
Practice Address - Street 1:5055 N.W 7 ST APT #609
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33126
Practice Address - Country:US
Practice Address - Phone:786-548-8089
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health