Provider Demographics
NPI:1093125858
Name:THE WELLNESS SPHERE
Entity Type:Organization
Organization Name:THE WELLNESS SPHERE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAOLA
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:DEL VALLE PATRON
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:786-542-5426
Mailing Address - Street 1:299 ALHAMBRA CIR
Mailing Address - Street 2:SUITE #316
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33134-5106
Mailing Address - Country:US
Mailing Address - Phone:786-542-5426
Mailing Address - Fax:
Practice Address - Street 1:299 ALHAMBRA CIR
Practice Address - Street 2:SUITE #316
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-5106
Practice Address - Country:US
Practice Address - Phone:756-742-5126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-02
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3340171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty