Healthcare Provider Details

I. General information

NPI: 1821965666
Provider Name (Legal Business Name): EL BIENESTAR COMMUNITY WELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20006 NW 79TH AVE
HIALEAH FL
33015-6610
US

IV. Provider business mailing address

20006 NW 79TH AVE
HIALEAH FL
33015-6610
US

V. Phone/Fax

Practice location:
  • Phone: 786-247-8941
  • Fax:
Mailing address:
  • Phone: 786-247-8941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DALIA YANES JORGE
Title or Position: CEO
Credential:
Phone: 786-247-8941