Provider Demographics
NPI:1467279257
Name:WELLNESS EMPOWERMENT LLC
Entity type:Organization
Organization Name:WELLNESS EMPOWERMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACKERY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-652-4198
Mailing Address - Street 1:328 NE 191ST
Mailing Address - Street 2:#286273
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3899
Mailing Address - Country:US
Mailing Address - Phone:347-652-4198
Mailing Address - Fax:
Practice Address - Street 1:116 SARONA CIR
Practice Address - Street 2:
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-4320
Practice Address - Country:US
Practice Address - Phone:347-652-4198
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center