Provider Demographics
NPI:1720807241
Name:WELLNESS MEDICAL CENTER GROUP INC
Entity type:Organization
Organization Name:WELLNESS MEDICAL CENTER GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FIDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERMUDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-648-2594
Mailing Address - Street 1:12550 BISCAYNE BLVD STE 800-6
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33181-2541
Mailing Address - Country:US
Mailing Address - Phone:561-648-2594
Mailing Address - Fax:
Practice Address - Street 1:12550 BISCAYNE BLVD STE 800-6
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33181-2541
Practice Address - Country:US
Practice Address - Phone:561-648-2594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center