Healthcare Provider Details

I. General information

NPI: 1104734888
Provider Name (Legal Business Name): AMP WELLNESS CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3JS27 VIA 55
CAROLINA PR
00983-4634
US

IV. Provider business mailing address

3JS27 VIA 55
CAROLINA PR
00983-4634
US

V. Phone/Fax

Practice location:
  • Phone: 321-444-0985
  • Fax:
Mailing address:
  • Phone: 321-444-0985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEJANDRA MENDEZ PERALTA
Title or Position: PSYCHIATRIST
Credential: MD
Phone: 321-444-0985