MEDICARE: KAMI WELLNESS CENTER INC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1073084067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAMI WELLNESS CENTER INC

Provider Business Mailing Address
First Line	:	5801 W HALLANDALE BEACH BLVD STE 200
Second Line	:
City	:	WEST PARK
State	:	FL
Zip	:	33023-5243
Country	:	US
Telephone Number	:	954-544-3400
Fax Number	:	954-544-2466

Provider Business Practice Location Address
First Line	:	3600 S STATE ROAD 7 STE 352
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-7203
Country	:	US
Telephone Number	:	954-802-8857
Fax Number	:	954-544-2466

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KAMLA JOHNSON
Credential	:
Telephone Number	:	954-544-3400

Provider Enumeration Date	:	12/17/2018
Last Update Date	:	04/07/2022

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