Healthcare Provider Details

I. General information

NPI: 1952531196
Provider Name (Legal Business Name): WELLMAX HEALTH MEDICAL CENTERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 04/06/2021
Certification Date: 04/06/2021
Deactivation Date: 03/05/2021
Reactivation Date: 04/03/2021

III. Provider practice location address

7928 SOUTHWEST 8 STREET
MIAMI FL
33144
US

IV. Provider business mailing address

9250 W FLAGLER ST STE 600
MIAMI FL
33174-3460
US

V. Phone/Fax

Practice location:
  • Phone: 305-261-5000
  • Fax: 305-262-3564
Mailing address:
  • Phone: 305-586-7288
  • Fax: 305-444-9148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MISS VANESSA VILLALI
Title or Position: DIR PRACTICE MANAGEMENT
Credential:
Phone: 305-586-7288