Provider Demographics
NPI:1871038588
Name:DOK WELLNESS, PLLC
Entity Type:Organization
Organization Name:DOK WELLNESS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:IVETTE
Authorized Official - Last Name:OSSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-240-1564
Mailing Address - Street 1:10710 NW 66TH ST
Mailing Address - Street 2:APT. 201
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33178-4555
Mailing Address - Country:US
Mailing Address - Phone:787-240-1564
Mailing Address - Fax:
Practice Address - Street 1:10710 NW 66TH ST
Practice Address - Street 2:APT. 201
Practice Address - City:DORAL
Practice Address - State:FL
Practice Address - Zip Code:33178-4555
Practice Address - Country:US
Practice Address - Phone:787-240-1564
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-04
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME-117566207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty