| Portofino Wellness Spa Llc | |
|
107 Westward Dr Unit 660515 Miami Springs FL 33266-0529 | |
| (305) 303-0649 | |
| (866) 885-9540 |
| Full Name | Portofino Wellness Spa Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 107 Westward Dr Unit 660515, Miami Springs, Florida |
| Authorized Official Name and Position | Thomas A Knigge (MANAGER / PRESIDENT) |
| Authorized Official Contact | 3053030649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portofino Wellness Spa Llc 107 Westward Dr Unit 660515 Miami Springs FL 33266-0529 Ph: (305) 303-0649 | Portofino Wellness Spa Llc 107 Westward Dr Unit 660515 Miami Springs FL 33266-0529 Ph: (305) 303-0649 |
| NPI Number | 1861929549 |
|---|---|
| Provider Enumeration Date | 05/12/2017 |
| Last Update Date | 05/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861929549 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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