Provider Demographics
NPI:1477243764
Name:WELLBEIN ORTHOPEDIC EXPRESS LLC
Entity Type:Organization
Organization Name:WELLBEIN ORTHOPEDIC EXPRESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISO
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:CAYCEDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:205-597-8647
Mailing Address - Street 1:2104 ROCKY RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35216-5138
Mailing Address - Country:US
Mailing Address - Phone:205-597-8647
Mailing Address - Fax:205-460-1133
Practice Address - Street 1:2104 ROCKY RIDGE RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-5138
Practice Address - Country:US
Practice Address - Phone:205-597-8647
Practice Address - Fax:205-460-1133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-10
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle SurgeryGroup - Single Specialty