Provider Demographics
NPI:1336426642
Name:TRUE CARE MEDICAL & WELLNESS CENTER INC
Entity Type:Organization
Organization Name:TRUE CARE MEDICAL & WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARSENIO
Authorized Official - Middle Name:
Authorized Official - Last Name:COLUMBIE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-838-2667
Mailing Address - Street 1:52 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-4842
Mailing Address - Country:US
Mailing Address - Phone:305-882-0502
Mailing Address - Fax:305-882-0515
Practice Address - Street 1:52 E 5TH ST
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-4842
Practice Address - Country:US
Practice Address - Phone:305-882-0502
Practice Address - Fax:305-882-0515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-15
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0036971208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL054657701Medicaid
FL95541Medicare PIN
FL054657701Medicaid