Provider Demographics
NPI:1154426591
Name:WELLINGTON INTERNAL MEDICINE GROUP PA
Entity type:Organization
Organization Name:WELLINGTON INTERNAL MEDICINE GROUP PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARMANDO
Authorized Official - Middle Name:ENRIQUE
Authorized Official - Last Name:MARULL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-753-8366
Mailing Address - Street 1:10131 W FOREST HILL BLVD # A
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-6156
Mailing Address - Country:US
Mailing Address - Phone:561-753-8366
Mailing Address - Fax:561-721-0077
Practice Address - Street 1:10131 W FOREST HILL BLVD # A
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-6156
Practice Address - Country:US
Practice Address - Phone:561-753-8366
Practice Address - Fax:561-721-0077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty