Provider Demographics
NPI:1710379771
Name:INSTITUTE 4 WELLNESS, INC
Entity Type:Organization
Organization Name:INSTITUTE 4 WELLNESS, INC
Other - Org Name:MEDXTRAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSSELI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-482-8179
Mailing Address - Street 1:2234 N FEDERAL HWY # 297
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7710
Mailing Address - Country:US
Mailing Address - Phone:954-482-8179
Mailing Address - Fax:
Practice Address - Street 1:375 SE 168TH CT
Practice Address - Street 2:
Practice Address - City:SILVER SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34488-5473
Practice Address - Country:US
Practice Address - Phone:954-482-8179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-28
Last Update Date:2015-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)