Healthcare Provider Details

I. General information

NPI: 1376418202
Provider Name (Legal Business Name): SMART WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 N KENDALL DR STE 304
MIAMI FL
33176-1469
US

IV. Provider business mailing address

10700 N KENDALL DR STE 304
MIAMI FL
33176-1469
US

V. Phone/Fax

Practice location:
  • Phone: 305-330-1066
  • Fax: 786-600-0686
Mailing address:
  • Phone: 305-330-1066
  • Fax: 786-600-0686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DAYNELIS NOA ORTEGA
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 305-330-1066