Provider Demographics
NPI:1790385342
Name:NEW FAMILY WELLNESS CENTER INC
Entity Type:Organization
Organization Name:NEW FAMILY WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:I
Authorized Official - Last Name:FONSECA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-298-2123
Mailing Address - Street 1:8200 NW 41ST ST STE 200-98
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33166-6205
Mailing Address - Country:US
Mailing Address - Phone:305-298-2123
Mailing Address - Fax:
Practice Address - Street 1:8200 NW 41ST ST STE 200-98
Practice Address - Street 2:
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33166-6205
Practice Address - Country:US
Practice Address - Phone:305-298-2123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-31
Last Update Date:2020-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)