Provider Demographics
NPI:1104418235
Name:NEGRIN COMMUNITY WELLNESS CENTER LLC
Entity type:Organization
Organization Name:NEGRIN COMMUNITY WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICARDO
Authorized Official - Middle Name:MIGUEL
Authorized Official - Last Name:NEGRIN MARRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-239-2753
Mailing Address - Street 1:686 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4402
Mailing Address - Country:US
Mailing Address - Phone:786-239-2753
Mailing Address - Fax:
Practice Address - Street 1:8410 W FLAGLER ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2092
Practice Address - Country:US
Practice Address - Phone:786-239-2753
Practice Address - Fax:786-580-4184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No251S00000XAgenciesCommunity/Behavioral Health