| Mco Wellness Center Llc | |
|
3300 W 84th St Unit 16 Hialeah FL 33018-4909 | |
| (305) 456-9267 | |
| (305) 456-9394 |
| Full Name | Mco Wellness Center Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 3300 W 84th St Unit 16, Hialeah, Florida |
| Authorized Official Name and Position | Maria C Oliva (PRESIDENT) |
| Authorized Official Contact | 3054569267 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mco Wellness Center Llc 3300 W 84th St Unit 16 Hialeah FL 33018-4909 Ph: (305) 456-9267 | Mco Wellness Center Llc 3300 W 84th St Unit 16 Hialeah FL 33018-4909 Ph: (305) 456-9267 |
| NPI Number | 1255020343 |
|---|---|
| Provider Enumeration Date | 05/04/2023 |
| Last Update Date | 10/25/2023 |
| Medicare PECOS PAC ID | 4183086986 |
|---|---|
| Medicare Enrollment ID | O20230810002138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255020343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Marta R Fernandez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780666750 PECOS PAC ID: 3779579578 Enrollment ID: I20040426000068 |
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