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General NPI Number Information
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NPI Number | 1114544418
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Entity Type | Organization
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Legal Business Name | WL WELL, LLC
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 2445 NE 14TH STREET CSWY
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City | POMPANO BEACH
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State | FL
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Zip | 33062-8267
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Country | US
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Telephone | 405-921-6935
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2112
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City | POMPANO BEACH
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State | FL
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Zip | 33061-2112
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Country | US
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Telephone | 561-508-8555
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Fax | 888-323-2806
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Authorized Official
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Title or Position | CEO
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Name | MR. MALIK LEIGH
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Credential |
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Telephone | 561-508-8555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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