Healthcare Provider Details

I. General information

NPI: 1235162744
Provider Name (Legal Business Name): CENTER FOR FAMILY HEALTH & WELLNESS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 05/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 HIATUS RD SUITE 100
COPPER CITY FL
33330
US

IV. Provider business mailing address

5900 HIATUS RD SUITE 100
COPPER CITY FL
33330
US

V. Phone/Fax

Practice location:
  • Phone: 954-252-7744
  • Fax: 954-252-7556
Mailing address:
  • Phone: 954-252-7744
  • Fax: 954-252-7556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MISS ERIKA FERNANDEZ
Title or Position: OFFICE COORDINATOR
Credential:
Phone: 954-252-7744