Healthcare Provider Details

I. General information

NPI: 1184427171
Provider Name (Legal Business Name): XANTOS WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W 12TH AVE STE 15
HIALEAH FL
33014-5154
US

IV. Provider business mailing address

2645 SW 37TH AVE STE 101
MIAMI FL
33133-2744
US

V. Phone/Fax

Practice location:
  • Phone: 305-395-4919
  • Fax: 305-395-4920
Mailing address:
  • Phone: 786-530-4080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: YENEY SANTOS
Title or Position: PRESIDENT
Credential:
Phone: 305-395-4919