Provider Demographics
NPI:1508473547
Name:CARDIO-WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:CARDIO-WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FELIX
Authorized Official - Middle Name:
Authorized Official - Last Name:BAEZ ALONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-323-4498
Mailing Address - Street 1:5614 SW 36TH ST
Mailing Address - Street 2:
Mailing Address - City:WEST PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33023-6106
Mailing Address - Country:US
Mailing Address - Phone:305-323-4498
Mailing Address - Fax:
Practice Address - Street 1:5614 SW 36TH ST
Practice Address - Street 2:
Practice Address - City:WEST PARK
Practice Address - State:FL
Practice Address - Zip Code:33023-6106
Practice Address - Country:US
Practice Address - Phone:305-323-4498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center