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General NPI Number Information
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NPI Number | 1336048792
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Entity Type | Organization
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Legal Business Name | WELLNESS CARE MANAGEMENT LLC
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Dates
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Enumeration Date | 11/03/2026
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Last Update Date | 11/03/2026
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Provider Practice Location Address
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Address Line | 433 PLAZA REAL
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City | BOCA RATON
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State | FL
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Zip | 33432-3932
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Country | US
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Telephone | 870-888-0627
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Fax | 870-888-0627
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Provider Business Mailing Address
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Address Line | 390 NE 191ST ST STE 43662
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City | MIAMI
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State | FL
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Zip | 33179-3899
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Country | US
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Telephone | 870-888-0627
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Fax | 870-888-0627
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Authorized Official
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Title or Position | MGR
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Name | PETER GILLOOLY
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Credential |
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Telephone | 870-888-0627
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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