Healthcare Provider Details

I. General information

NPI: 1306085840
Provider Name (Legal Business Name): FITNESS & WELLNESS WORKS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2009
Last Update Date: 02/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8396 SW 8TH ST 2ND FLOOR
MIAMI FL
33144-4180
US

IV. Provider business mailing address

8396 SW 8TH ST 2ND FLOOR
MIAMI FL
33144-4180
US

V. Phone/Fax

Practice location:
  • Phone: 305-260-9803
  • Fax: 305-260-9298
Mailing address:
  • Phone: 305-260-9803
  • Fax: 305-260-9298

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: MR. RAFAEL CANELO
Title or Position: CEO
Credential:
Phone: 954-465-6900