| Medical Wellness Center Llc | |
|
10031 Sw 40th St Miami FL 33165-3945 | |
| (786) 422-9628 | |
| Not Available |
| Full Name | Medical Wellness Center Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10031 Sw 40th St, Miami, Florida |
| Authorized Official Name and Position | Alfredo Alvarez (MBR/CEO) |
| Authorized Official Contact | 7864229628 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Wellness Center Llc 10031 Sw 40th St Miami FL 33165-3945 Ph: (786) 422-9628 | Medical Wellness Center Llc 10031 Sw 40th St Miami FL 33165-3945 Ph: (786) 422-9628 |
| NPI Number | 1871102160 |
|---|---|
| Provider Enumeration Date | 07/23/2020 |
| Last Update Date | 10/24/2022 |
| Medicare PECOS PAC ID | 2163828807 |
|---|---|
| Medicare Enrollment ID | O20210907000539 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871102160 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jose A Guerra-valencia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154673770 PECOS PAC ID: 6507187051 Enrollment ID: I20150609001381 |
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