Provider Demographics
NPI:1902795446
Name:WELLNESS OPPORTUNITY & WEIGHT LOSS MEDICAL CENTER INC
Entity type:Organization
Organization Name:WELLNESS OPPORTUNITY & WEIGHT LOSS MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:L
Authorized Official - Last Name:CRESPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-369-6702
Mailing Address - Street 1:3869 NW 62ND CT
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-2129
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3869 NW 62ND CT
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-2129
Practice Address - Country:US
Practice Address - Phone:786-369-6702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty