Provider Demographics
NPI:1164163945
Name:WECARE WELLNESS CLINIC LLC
Entity Type:Organization
Organization Name:WECARE WELLNESS CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARLYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGES
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:813-438-5220
Mailing Address - Street 1:PO BOX 1679
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33509-1679
Mailing Address - Country:US
Mailing Address - Phone:813-438-5220
Mailing Address - Fax:
Practice Address - Street 1:214 W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5104
Practice Address - Country:US
Practice Address - Phone:813-244-0696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WECARE WELLNESS CLINIC LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-04-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center