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General NPI Number Information
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NPI Number | 1023388915
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Entity Type | Organization
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Legal Business Name | THE WELLNESS CENTER AT POST HASTE
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Dates
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Enumeration Date | 01/09/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 4401 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3513
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Country | US
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Telephone | 954-239-7179
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Fax | 954-874-6237
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Provider Business Mailing Address
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Address Line | 4401 SHERIDAN ST
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City | HOLLYWOOD
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State | FL
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Zip | 33021-3513
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Country | US
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Telephone | 954-239-7179
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Fax | 954-874-6237
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. CARLOS SANCHEZ
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Credential | DO
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Telephone | 954-239-7179
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | OS7598
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License Number State | FL
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