MEDICARE: THE MOTIVATIONAL EDGE

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	:	1841755402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MOTIVATIONAL EDGE

Provider Business Mailing Address
First Line	:	2103 CORAL WAY FL 2
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33145-2601
Country	:	US
Telephone Number	:	786-269-9831
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 NW 36TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33142-5560
Country	:	US
Telephone Number	:	786-542-1609
Fax Number	:

Authorized Official
Title or Position	:	FOUNDER AND CEO
Name	:	IAN WELSCH
Credential	:
Telephone Number	:	786-269-9831

Provider Enumeration Date	:	02/07/2019
Last Update Date	:	02/07/2019

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Directions to “THE MOTIVATIONAL EDGE ” Practice Location

Language	Start Address	Practice Location

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