Provider Demographics
NPI:1689984932
Name:WELLNESS THERAPY & MEDICAL CARE CENTER INC
Entity Type:Organization
Organization Name:WELLNESS THERAPY & MEDICAL CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-827-0208
Mailing Address - Street 1:1140 W 50TH ST STE 301
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33012-3411
Mailing Address - Country:US
Mailing Address - Phone:305-827-0208
Mailing Address - Fax:305-827-0280
Practice Address - Street 1:1140 W 50TH ST STE 301
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-3411
Practice Address - Country:US
Practice Address - Phone:305-827-0208
Practice Address - Fax:305-827-0280
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-19
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
FLHCC261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No251S00000XAgenciesCommunity/Behavioral Health