Provider Demographics
NPI:1376836049
Name:HEALTH & WELLNESS INSTITUTE OF SOUTH FLORIDA INC
Entity Type:Organization
Organization Name:HEALTH & WELLNESS INSTITUTE OF SOUTH FLORIDA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JHAWED
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAYOUMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-596-6218
Mailing Address - Street 1:1551 N FLAGLER DR
Mailing Address - Street 2:#612
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-3438
Mailing Address - Country:US
Mailing Address - Phone:561-596-6218
Mailing Address - Fax:
Practice Address - Street 1:301 S GLORIA ST
Practice Address - Street 2:
Practice Address - City:CLEWISTON
Practice Address - State:FL
Practice Address - Zip Code:33440-3520
Practice Address - Country:US
Practice Address - Phone:863-983-5123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106253311ZA0620X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home