| Embracing Changes Center For Wellness Llc | |
|
4830 W Kennedy Blvd Ste 630 Tampa FL 33609-2571 | |
| (813) 486-4920 | |
| (813) 428-5756 |
| Full Name | Embracing Changes Center For Wellness Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4830 W Kennedy Blvd Ste 630, Tampa, Florida |
| Authorized Official Name and Position | Karen Perez (PRESIDENT) |
| Authorized Official Contact | 8134937705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Embracing Changes Center For Wellness Llc 32450 Talimena Loop Wesley Chapel FL 33543-5839 Ph: (813) 486-4920 | Embracing Changes Center For Wellness Llc 4830 W Kennedy Blvd Ste 630 Tampa FL 33609-2571 Ph: (813) 486-4920 |
| NPI Number | 1003477662 |
|---|---|
| Provider Enumeration Date | 06/25/2019 |
| Last Update Date | 02/21/2022 |
| Certification Date | 02/17/2021 |
| Medicare PECOS PAC ID | 1951713361 |
|---|---|
| Medicare Enrollment ID | O20201209000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003477662 | NPI | - | NPPES |
| SW11254 | Other | FL | DOH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Karen Perez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649485822 PECOS PAC ID: 3375767494 Enrollment ID: I20140611001854 |
| Provider Name | Regina May Velasco |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851407613 PECOS PAC ID: 7012153703 Enrollment ID: I20201209001312 |
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