Healthcare Provider Details

I. General information

NPI: 1013869890
Provider Name (Legal Business Name): WELMIVIA MEDICAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 MARYLAND DRIVE STE 1
RICHMOND VA
23294
US

IV. Provider business mailing address

148 BRANDYWINE CT
CHARLOTTESVILLE VA
22901-2846
US

V. Phone/Fax

Practice location:
  • Phone: 434-623-0003
  • Fax:
Mailing address:
  • Phone: 434-623-0003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SONIA MIA DIAZ
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 407-340-4607