Healthcare Provider Details

I. General information

NPI: 1619708930
Provider Name (Legal Business Name): MIAMI WELLNESS AND THERAPY CENTER LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/08/2024
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5040 NW 7TH ST STE 685
MIAMI FL
33126-3432
US

IV. Provider business mailing address

5040 NW 7TH ST STE 685
MIAMI FL
33126-3432
US

V. Phone/Fax

Practice location:
  • Phone: 786-929-7908
  • Fax:
Mailing address:
  • Phone: 786-929-7908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MR. RAMON RAMIREZ
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 786-929-7908