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General NPI Number Information
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NPI Number | 1063991172
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Entity Type | Organization
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Legal Business Name | ANCHOR PLUS WELLNESS LLC
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Dates
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Enumeration Date | 08/09/2018
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Last Update Date | 08/09/2018
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Provider Practice Location Address
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Address Line | 5180 OVERSEAS HWY
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City | MARATHON
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State | FL
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Zip | 33050-2624
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Country | US
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Telephone | 305-517-6995
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Fax | 305-517-6335
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Provider Business Mailing Address
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Address Line | 5180 OVERSEAS HWY
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City | MARATHON
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State | FL
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Zip | 33050-2624
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Country | US
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Telephone | 305-517-6995
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Fax | 305-517-6335
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Authorized Official
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Title or Position | AMBR
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Name | MARIMER RENSOLI VELAZQUEZ
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Credential | MD
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Telephone | 305-517-6995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME132812
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License Number State | FL
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