Provider Demographics
NPI:1861859027
Name:DORAL HEALTH & WELLNESS CENTER INC
Entity Type:Organization
Organization Name:DORAL HEALTH & WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUISA
Authorized Official - Middle Name:FERNANDA
Authorized Official - Last Name:SOSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-866-7899
Mailing Address - Street 1:7221 SW 24TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1436
Mailing Address - Country:US
Mailing Address - Phone:786-866-7899
Mailing Address - Fax:786-999-6502
Practice Address - Street 1:7221 SW 24TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33155-1436
Practice Address - Country:US
Practice Address - Phone:786-866-7899
Practice Address - Fax:786-999-6502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-19
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL111N00000X
208100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty