Healthcare Provider Details

I. General information

NPI: 1497602163
Provider Name (Legal Business Name): VICTORIA WELLNESS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2026
Last Update Date: 03/12/2026
Certification Date: 03/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2123 NE 28TH ST
CAPE CORAL FL
33909-4582
US

IV. Provider business mailing address

2123 NE 28TH ST
CAPE CORAL FL
33909-4582
US

V. Phone/Fax

Practice location:
  • Phone: 305-510-6698
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: AMERICA GUZMAN CARRERA
Title or Position: CEO
Credential:
Phone: 305-510-6698