Healthcare Provider Details

I. General information

NPI: 1659208114
Provider Name (Legal Business Name): PRO-MED WELLNESS & THERAPY CENTER CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13205 SW 137TH AVE STE 212
MIAMI FL
33186-5335
US

IV. Provider business mailing address

13205 SW 137TH AVE STE 212
MIAMI FL
33186-5335
US

V. Phone/Fax

Practice location:
  • Phone: 305-796-4324
  • Fax: 786-732-6278
Mailing address:
  • Phone: 305-796-4324
  • Fax: 786-732-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEIDYS MENDEZ-CHUMACEIRO
Title or Position: PRESIDENT
Credential:
Phone: 305-796-4324