Provider Demographics
NPI:1750822557
Name:HOMESTEAD HEALTH AND WELLNESS CENTER INC
Entity Type:Organization
Organization Name:HOMESTEAD HEALTH AND WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-252-9485
Mailing Address - Street 1:9780 E INDIGO ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-5609
Mailing Address - Country:US
Mailing Address - Phone:305-252-9485
Mailing Address - Fax:305-252-9486
Practice Address - Street 1:125 NE 8TH ST
Practice Address - Street 2:SUITE 4
Practice Address - City:HOMESTEAD
Practice Address - State:FL
Practice Address - Zip Code:33030-4676
Practice Address - Country:US
Practice Address - Phone:305-247-8585
Practice Address - Fax:305-246-8109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty