=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326991761
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WELLGROVE MEDICAL PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/16/2026
-----------------------------------------------------
Last Update Date | 02/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9420 SW 77TH AVE STE 201A
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33156-2501
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-481-3404
-----------------------------------------------------
Fax | 786-590-1517
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11277 SW 152ND ST # 289
-----------------------------------------------------
City | MIAMI
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33157-1101
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-481-3404
-----------------------------------------------------
Fax | 786-590-1517
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN OWNER
-----------------------------------------------------
Name | NATALIA URIBE
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 786-481-3404
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------