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General NPI Number Information
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NPI Number | 1376836049
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Entity Type | Organization
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Legal Business Name | HEALTH & WELLNESS INSTITUTE OF SOUTH FLORIDA INC
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 05/27/2011
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Provider Practice Location Address
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Address Line | 301 S GLORIA ST
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City | CLEWISTON
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State | FL
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Zip | 33440-3520
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Country | US
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Telephone | 863-983-5123
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Fax |
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Provider Business Mailing Address
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Address Line | 1551 N FLAGLER DR #612
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City | WEST PALM BEACH
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State | FL
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Zip | 33401-3438
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Country | US
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Telephone | 561-596-6218
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. JHAWED KHAYOUMI
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Credential | M.D.
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Telephone | 561-596-6218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | ME106253
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | ME106253
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License Number State | FL
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