Provider Demographics
NPI:1881421824
Name:MED-WELL HEALTHCARE SPECIALISTS INC
Entity type:Organization
Organization Name:MED-WELL HEALTHCARE SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-606-9181
Mailing Address - Street 1:2450 SW 137TH AVE STE 234
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6333
Mailing Address - Country:US
Mailing Address - Phone:305-381-5420
Mailing Address - Fax:305-381-5335
Practice Address - Street 1:2450 SW 137TH AVE STE 234
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33175-6333
Practice Address - Country:US
Practice Address - Phone:305-381-5420
Practice Address - Fax:305-381-5335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center