Healthcare Provider Details

I. General information

NPI: 1952808792
Provider Name (Legal Business Name): HEALTH AND WELLNESS TECHNOLOGIES II INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2018
Last Update Date: 04/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9655 BOYNTON BEACH BLVD
BOYNTON BEACH FL
33472-4421
US

IV. Provider business mailing address

3014 SIENA CIR
WELLINGTON FL
33414-4397
US

V. Phone/Fax

Practice location:
  • Phone: 561-336-7000
  • Fax:
Mailing address:
  • Phone: 561-596-6218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME106253
License Number StateFL

VIII. Authorized Official

Name: JHAWED KHAYOUMI
Title or Position: OWNER
Credential: MD
Phone: 561-596-6218