| Family Wellness And Aesthetic Center Llc | |
|
7800 W Oakland Park Blvd Ste B105 Sunrise FL 33351-6741 | |
| (954) 890-3892 | |
| (954) 999-0230 |
| Full Name | Family Wellness And Aesthetic Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 7800 W Oakland Park Blvd Ste B105, Sunrise, Florida |
| Authorized Official Name and Position | Fanuel Dorilas (PRESIDENT) |
| Authorized Official Contact | 9544782041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Wellness And Aesthetic Center Llc 7800 W Oakland Park Blvd Ste B105 Sunrise FL 33351-6741 Ph: (954) 890-3892 | Family Wellness And Aesthetic Center Llc 7800 W Oakland Park Blvd Ste B105 Sunrise FL 33351-6741 Ph: (954) 890-3892 |
| NPI Number | 1437798139 |
|---|---|
| Provider Enumeration Date | 12/27/2019 |
| Last Update Date | 04/26/2022 |
| Medicare PECOS PAC ID | 0749610152 |
|---|---|
| Medicare Enrollment ID | O20200428000085 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437798139 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Fanuel Dorilas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861717514 PECOS PAC ID: 1951533918 Enrollment ID: I20140407001279 |
| Provider Name | Jennifer Lovelace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033625900 PECOS PAC ID: 5698014843 Enrollment ID: I20190305002610 |
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