Provider Demographics
NPI:1801472485
Name:SALUD Y BIENESTAR MEDICAL GROUP LLC
Entity type:Organization
Organization Name:SALUD Y BIENESTAR MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-598-5475
Mailing Address - Street 1:2916 W WATERS AVE STE A1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1869
Mailing Address - Country:US
Mailing Address - Phone:813-598-5475
Mailing Address - Fax:
Practice Address - Street 1:2916 W WATERS AVE STE A1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1869
Practice Address - Country:US
Practice Address - Phone:813-598-5475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)