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General NPI Number Information
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NPI Number | 1235752460
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Entity Type | Organization
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Legal Business Name | WHEAT L L C
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Dates
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Enumeration Date | 05/21/2020
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Last Update Date | 10/18/2025
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Provider Practice Location Address
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Address Line | 2627 NE 203RD ST STE 109
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City | MIAMI
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State | FL
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Zip | 33180-1945
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Country | US
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Telephone | 305-528-2836
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Fax | 305-682-8994
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Provider Business Mailing Address
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Address Line | 2627 NE 203RD ST STE 109
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City | MIAMI
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State | FL
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Zip | 33180-1945
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Country | US
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Telephone | 305-682-8700
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Fax | 305-682-8994
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Authorized Official
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Title or Position | DIRECTOR
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Name | REGINA F COOPER
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Credential |
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Telephone | 954-661-7227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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