Healthcare Provider Details

I. General information

NPI: 1295433811
Provider Name (Legal Business Name): ALL WELLNESS COMMUNITY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2023
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 NW 72ND AVE STE 100
MIAMI FL
33126-1920
US

IV. Provider business mailing address

1150 NW 72ND AVE STE 100
MIAMI FL
33126-1920
US

V. Phone/Fax

Practice location:
  • Phone: 786-416-0811
  • Fax: 786-558-5483
Mailing address:
  • Phone: 786-416-0811
  • Fax: 786-558-5483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VANIA MERCEDES SIMON
Title or Position: PRESIDENT
Credential: LMHC
Phone: 786-416-0811