Healthcare Provider Details

I. General information

NPI: 1003371519
Provider Name (Legal Business Name): AFFORDABLE MEDICAL CLINIC OF WELLII
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 02/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12773 FOREST HILL BLVD STE 1203
WELLINGTON FL
33414-4760
US

IV. Provider business mailing address

12773 FOREST HILL BLVD STE 1203
WELLINGTON FL
33414-4760
US

V. Phone/Fax

Practice location:
  • Phone: 561-758-2271
  • Fax:
Mailing address:
  • Phone: 561-758-2271
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID DREXLER
Title or Position: PRESIDENT
Credential: D.O
Phone: 561-758-2271