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General NPI Number Information
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NPI Number | 1346128907
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Entity Type | Organization
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Legal Business Name | ELITE WELLNESS CLUB
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Dates
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Enumeration Date | 08/22/2025
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Last Update Date | 08/28/2025
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Provider Practice Location Address
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Address Line | 28 W FLAGLER ST STE 550
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City | MIAMI
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State | FL
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Zip | 33130-1891
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Country | US
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Telephone | 786-907-4904
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Fax |
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Provider Business Mailing Address
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Address Line | 28 W FLAGLER ST STE 550
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City | MIAMI
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State | FL
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Zip | 33130-1891
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Country | US
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Telephone | 786-907-4904
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. EDIRIS OJEDA
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Credential |
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Telephone | 713-998-1018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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