Healthcare Provider Details

I. General information

NPI: 1649982620
Provider Name (Legal Business Name): JUSTWELL FOX HOLDINGS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 W FLAGLER ST
MIAMI FL
33130-1202
US

IV. Provider business mailing address

2600 S DOUGLAS RD STE 400
CORAL GABLES FL
33134-6134
US

V. Phone/Fax

Practice location:
  • Phone: 305-545-9292
  • Fax: 305-545-9259
Mailing address:
  • Phone: 305-614-4700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. DAIMILSIS SALGADO
Title or Position: DIRECTOR OF PROVIDER RELATIONS
Credential:
Phone: 305-614-7740