Provider Demographics
NPI:1285376541
Name:Y&D WELLNESS CENTER LLC
Entity type:Organization
Organization Name:Y&D WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:YAIBISLEIVYS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-352-0299
Mailing Address - Street 1:31 TAMIAMI CANAL RD
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-2538
Mailing Address - Country:US
Mailing Address - Phone:305-330-9054
Mailing Address - Fax:
Practice Address - Street 1:31 TAMIAMI CANAL RD
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2538
Practice Address - Country:US
Practice Address - Phone:305-330-9054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-08
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center