Provider Demographics
NPI:1477005262
Name:WELLMAX MEDICAL CENTERS LLC
Entity Type:Organization
Organization Name:WELLMAX MEDICAL CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR PRACTICE MANAGEMENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-586-7288
Mailing Address - Street 1:9250 W FLAGLER ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3460
Mailing Address - Country:US
Mailing Address - Phone:305-448-8100
Mailing Address - Fax:
Practice Address - Street 1:1422 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125-3700
Practice Address - Country:US
Practice Address - Phone:305-631-8080
Practice Address - Fax:305-631-8030
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLMAX MEDICAL CENTERS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-27
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty