Provider Demographics
NPI:1104786144
Name:FAMILY WELLNESS CLINIC
Entity type:Organization
Organization Name:FAMILY WELLNESS CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/ ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MIRIAM
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:ZAPATA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:305-731-0223
Mailing Address - Street 1:2960 MAGUIRE RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:OCOEE
Mailing Address - State:FL
Mailing Address - Zip Code:34761-4755
Mailing Address - Country:US
Mailing Address - Phone:407-347-7267
Mailing Address - Fax:321-256-5349
Practice Address - Street 1:2960 MAGUIRE RD UNIT A
Practice Address - Street 2:
Practice Address - City:OCOEE
Practice Address - State:FL
Practice Address - Zip Code:34761-4755
Practice Address - Country:US
Practice Address - Phone:407-347-7267
Practice Address - Fax:321-256-5349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-13
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty