Provider Demographics
NPI:1225312606
Name:INSTITUTE FOR FAMILY WELLNESS INC
Entity Type:Organization
Organization Name:INSTITUTE FOR FAMILY WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:VLADIMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-305-3215
Mailing Address - Street 1:2030 E BROADWAY BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-5905
Mailing Address - Country:US
Mailing Address - Phone:520-305-3215
Mailing Address - Fax:520-305-3215
Practice Address - Street 1:2030 E BROADWAY BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-5905
Practice Address - Country:US
Practice Address - Phone:520-305-3215
Practice Address - Fax:520-305-3215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2012-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ149859Medicare PIN