Healthcare Provider Details

I. General information

NPI: 1174908214
Provider Name (Legal Business Name): BWELL RESEARCH CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2015
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 SW 137TH AVE # 251-252
MIAMI FL
33175-8803
US

IV. Provider business mailing address

2460 SW 137TH AVE # 251-252
MIAMI FL
33175-8803
US

V. Phone/Fax

Practice location:
  • Phone: 305-223-2777
  • Fax:
Mailing address:
  • Phone: 305-223-2777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1100X
TaxonomyResearch Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIA BELEN SALVADOR
Title or Position: ADMINISTRATIVE ASSISATNT
Credential:
Phone: 305-223-2777