Provider Demographics
NPI:1316381288
Name:WELLNESS GROUP OF SUNSET STRIP, LLC
Entity Type:Organization
Organization Name:WELLNESS GROUP OF SUNSET STRIP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DR. FARID
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSOUAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-990-7101
Mailing Address - Street 1:PO BOX 8895
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33075-8895
Mailing Address - Country:US
Mailing Address - Phone:954-990-7101
Mailing Address - Fax:954-990-7106
Practice Address - Street 1:1060 SUNSET STRIP
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33313-6106
Practice Address - Country:US
Practice Address - Phone:954-990-7101
Practice Address - Fax:954-990-7106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-23
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Multi-Specialty