| Health Source Wellness Center | |
|
100 E Sample Rd Suite 320 Pompano Beach FL 33064-3554 | |
| (754) 264-7540 | |
| (754) 222-9389 |
| Full Name | Health Source Wellness Center |
|---|---|
| Speciality | Internal Medicine |
| Location | 100 E Sample Rd, Pompano Beach, Florida |
| Authorized Official Name and Position | Raymond Di Iulio (MANAGING MEMBER) |
| Authorized Official Contact | 7542647540 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Source Wellness Center 100 E Sample Rd Suite 320 Pompano Beach FL 33064-3554 Ph: (754) 264-7540 | Health Source Wellness Center 100 E Sample Rd Suite 320 Pompano Beach FL 33064-3554 Ph: (754) 264-7540 |
| NPI Number | 1306214606 |
|---|---|
| Provider Enumeration Date | 09/03/2015 |
| Last Update Date | 07/24/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306214606 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
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