Provider Demographics
NPI:1699083931
Name:TRI R WELLNESS CENTER
Entity type:Organization
Organization Name:TRI R WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARCOS
Authorized Official - Middle Name:
Authorized Official - Last Name:REMEDIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-477-5151
Mailing Address - Street 1:1414 NW 107TH AVE
Mailing Address - Street 2:STE 214
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33172-2732
Mailing Address - Country:US
Mailing Address - Phone:305-477-5151
Mailing Address - Fax:305-477-5103
Practice Address - Street 1:1414 NW 107TH AVE
Practice Address - Street 2:STE 214
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33172-2732
Practice Address - Country:US
Practice Address - Phone:305-477-5151
Practice Address - Fax:305-477-5103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMM24985225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty