Provider Demographics
NPI:1922252121
Name:WELLINGTON MEDSTAT LLC
Entity Type:Organization
Organization Name:WELLINGTON MEDSTAT LLC
Other - Org Name:ER DOCTORS URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:MENENDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-333-4000
Mailing Address - Street 1:3319 SR 7
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33449
Mailing Address - Country:US
Mailing Address - Phone:561-333-4000
Mailing Address - Fax:
Practice Address - Street 1:3319 STATE ROAD 7
Practice Address - Street 2:SUITE 102
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33449-8094
Practice Address - Country:US
Practice Address - Phone:561-333-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-14
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care