Healthcare Provider Details

I. General information

NPI: 1134716848
Provider Name (Legal Business Name): WELLMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2020
Last Update Date: 12/29/2020
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6766 W SUNRISE BLVD STE 100
PLANTATION FL
33313-6072
US

IV. Provider business mailing address

401 FAN PALM WAY
PLANTATION FL
33324-8222
US

V. Phone/Fax

Practice location:
  • Phone: 954-583-8472
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANJALI BHASIN
Title or Position: OWNER
Credential: MD
Phone: 954-583-8472