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General NPI Number Information
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NPI Number | 1265382337
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Entity Type | Organization
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Legal Business Name | WELLCARE INTEGRAL CLINIC CORP
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 26315 SW 128TH CT
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City | HOMESTEAD
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State | FL
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Zip | 33032-6915
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Country | US
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Telephone | 786-908-7206
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Fax |
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Provider Business Mailing Address
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Address Line | 26315 SW 128TH CT
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City | HOMESTEAD
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State | FL
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Zip | 33032-6915
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Country | US
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Telephone | 786-908-7206
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MS. KELLYS M CAMPOS
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Credential |
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Telephone | 786-870-0068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 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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