Provider Demographics
NPI:1114958873
Name:PHYSICIANS WELLNESS CARE INC
Entity Type:Organization
Organization Name:PHYSICIANS WELLNESS CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:561-964-9191
Mailing Address - Street 1:6894 LAKE WORTH RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2964
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6894 LAKE WORTH RD
Practice Address - Street 2:SUITE 104
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2964
Practice Address - Country:US
Practice Address - Phone:561-964-9191
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 7582111NS0005X
FLME 60439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262388900Medicaid
FL38191Medicare ID - Type Unspecified
FL6215210001Medicare NSC