Provider Demographics
NPI:1417396649
Name:TROPICAL WELLNESS CENTER, LLC
Entity Type:Organization
Organization Name:TROPICAL WELLNESS CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-501-3300
Mailing Address - Street 1:911 COLUMBUS AVE
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32901-4605
Mailing Address - Country:US
Mailing Address - Phone:321-501-3300
Mailing Address - Fax:
Practice Address - Street 1:4700 DIXIE HWY NE
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32905-6036
Practice Address - Country:US
Practice Address - Phone:321-501-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility