Provider Demographics
NPI:1750966818
Name:SOUTH FLORIDA HEALTH AND WELLNESS CENTER CORP
Entity type:Organization
Organization Name:SOUTH FLORIDA HEALTH AND WELLNESS CENTER CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LIZET
Authorized Official - Middle Name:
Authorized Official - Last Name:DIBERNARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-732-9817
Mailing Address - Street 1:3017 EXCHANGE CT
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409
Mailing Address - Country:US
Mailing Address - Phone:954-732-9817
Mailing Address - Fax:561-342-0064
Practice Address - Street 1:3017 EXECUTIVE COURT
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409
Practice Address - Country:US
Practice Address - Phone:305-206-2553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-10
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No251K00000XAgenciesPublic Health or Welfare
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty