MEDICARE: SCRUGGS WELLNESS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1053150888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCRUGGS WELLNESS LLC

Provider Business Mailing Address
First Line	:	2332 GALIANO ST FL 2
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5402
Country	:	US
Telephone Number	:	786-733-6197
Fax Number	:

Provider Business Practice Location Address
First Line	:	2332 GALIANO ST FL 2
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-5402
Country	:	US
Telephone Number	:	786-733-6197
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	ANDREW SCRUGGS
Credential	:
Telephone Number	:	786-733-6197

Provider Enumeration Date	:	05/21/2024
Last Update Date	:	02/15/2026

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