| Wellcare Med Group Corp | |
|
14261 Commerce Way Ste 203 Miami Lakes FL 33016-1647 | |
| (305) 698-4000 | |
| (305) 698-4014 |
| Full Name | Wellcare Med Group Corp |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 14261 Commerce Way Ste 203, Miami Lakes, Florida |
| Authorized Official Name and Position | Bashar A Mohsen (OWNER) |
| Authorized Official Contact | 3056984000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellcare Med Group Corp 14261 Commerce Way Ste 203 Miami Lakes FL 33016-1647 Ph: (305) 698-4000 | Wellcare Med Group Corp 14261 Commerce Way Ste 203 Miami Lakes FL 33016-1647 Ph: (305) 698-4000 |
| NPI Number | 1235793357 |
|---|---|
| Provider Enumeration Date | 04/24/2019 |
| Last Update Date | 10/11/2023 |
| Certification Date | 10/11/2023 |
| Medicare PECOS PAC ID | 2466884416 |
|---|---|
| Medicare Enrollment ID | O20191113003287 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235793357 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Bashar A Mohsen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114953650 PECOS PAC ID: 0648275917 Enrollment ID: I20120924000691 |
| Provider Name | Christopher Patino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053895078 PECOS PAC ID: 5597140905 Enrollment ID: I20220921003297 |
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