Healthcare Provider Details

I. General information

NPI: 1003427832
Provider Name (Legal Business Name): T.A HEALTH AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2020
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5600 SW 135TH AVE STE 202B
MIAMI FL
33183-5101
US

IV. Provider business mailing address

5600 SW 135TH AVE STE 202B
MIAMI FL
33183-5101
US

V. Phone/Fax

Practice location:
  • Phone: 786-856-4499
  • Fax:
Mailing address:
  • Phone: 786-856-4499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MRS. TAIMARA ALFONSO MARTINEZ
Title or Position: CEO
Credential: M.S
Phone: 786-856-4499