Provider Demographics
NPI:1427331479
Name:SOLUTIONS WELLNESS CENTER CORP
Entity type:Organization
Organization Name:SOLUTIONS WELLNESS CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HUMBERTO
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOLGORA
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:786-285-8181
Mailing Address - Street 1:3408 W 84TH ST STE 112
Mailing Address - Street 2:
Mailing Address - City:HIALEAH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33018-4941
Mailing Address - Country:US
Mailing Address - Phone:954-224-3423
Mailing Address - Fax:954-874-6223
Practice Address - Street 1:3408 W 84TH ST STE 112
Practice Address - Street 2:
Practice Address - City:HIALEAH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33018-4941
Practice Address - Country:US
Practice Address - Phone:954-224-3423
Practice Address - Fax:954-874-6223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-26
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM27802261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC101DOtherBCBS OF FLORIDA
FLMA1540500Medicaid