| Shalom Wellness Center Corp. | |
|
4995 Nw 72nd Ave Ste 209 Miami FL 33166-5643 | |
| (786) 651-4190 | |
| Not Available |
| Full Name | Shalom Wellness Center Corp. |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 4995 Nw 72nd Ave Ste 209, Miami, Florida |
| Authorized Official Name and Position | Pedro Luis Jimenez Pulido (ADMINISTRATOR) |
| Authorized Official Contact | 7866514190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shalom Wellness Center Corp. 4995 Nw 72nd Ave Ste 209 Miami FL 33166-5643 Ph: (786) 651-4190 | Shalom Wellness Center Corp. 4995 Nw 72nd Ave Ste 209 Miami FL 33166-5643 Ph: (786) 651-4190 |
| NPI Number | 1205663671 |
|---|---|
| Provider Enumeration Date | 09/18/2024 |
| Last Update Date | 09/25/2024 |
| Certification Date | 09/25/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205663671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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