Healthcare Provider Details

I. General information

NPI: 1386326890
Provider Name (Legal Business Name): CAREWELL MED LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2023
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 E HALLANDALE BEACH BLVD STE 101B
HALLANDALE BEACH FL
33009-3722
US

IV. Provider business mailing address

4711 SW 143RD CT
MIAMI FL
33175-6894
US

V. Phone/Fax

Practice location:
  • Phone: 305-345-2080
  • Fax: 954-231-7025
Mailing address:
  • Phone: 305-345-2080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: HENRY MORAN
Title or Position: MANAGER MEMBER
Credential:
Phone: 305-345-2080