Provider Demographics
NPI:1962938928
Name:COMMUNITY HEALTH AND WELLNESS CENTER OF MIAMI
Entity type:Organization
Organization Name:COMMUNITY HEALTH AND WELLNESS CENTER OF MIAMI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MASIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOREIRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-515-3156
Mailing Address - Street 1:1671 W 37TH ST
Mailing Address - Street 2:STE 4
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-4639
Mailing Address - Country:US
Mailing Address - Phone:305-729-4880
Mailing Address - Fax:305-390-0084
Practice Address - Street 1:759 NW 22ND AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3339
Practice Address - Country:US
Practice Address - Phone:305-541-5245
Practice Address - Fax:305-649-0496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty