Provider Demographics
NPI:1053663518
Name:QUALITY HEALTH & WELLNESS CENTER COPR
Entity Type:Organization
Organization Name:QUALITY HEALTH & WELLNESS CENTER COPR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SANTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LA PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-225-2744
Mailing Address - Street 1:2460 SW 137TH AVE STE 249
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6399
Mailing Address - Country:US
Mailing Address - Phone:305-225-2744
Mailing Address - Fax:305-225-7544
Practice Address - Street 1:2460 SW 137TH AVE STE 249
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6399
Practice Address - Country:US
Practice Address - Phone:305-225-2744
Practice Address - Fax:305-225-7544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation PractitionerGroup - Multi-Specialty