Provider Demographics
NPI:1407434053
Name:WELLNESS COMMUNITY & MEDICAL INC
Entity Type:Organization
Organization Name:WELLNESS COMMUNITY & MEDICAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA DE LOS ANGELES
Authorized Official - Middle Name:
Authorized Official - Last Name:CRUZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-536-6625
Mailing Address - Street 1:946 E 25TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3404
Mailing Address - Country:US
Mailing Address - Phone:786-536-6625
Mailing Address - Fax:786-280-1900
Practice Address - Street 1:946 E 25TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3404
Practice Address - Country:US
Practice Address - Phone:786-536-6625
Practice Address - Fax:786-280-1900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health