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General NPI Number Information
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NPI Number | 1427331479
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Entity Type | Organization
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Legal Business Name | SOLUTIONS WELLNESS CENTER CORP
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Dates
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Enumeration Date | 09/26/2011
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 3408 W 84TH ST STE 112
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4941
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Country | US
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Telephone | 954-224-3423
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Fax | 954-874-6223
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Provider Business Mailing Address
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Address Line | 3408 W 84TH ST STE 112
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City | HIALEAH GARDENS
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State | FL
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Zip | 33018-4941
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Country | US
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Telephone | 954-224-3423
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Fax | 954-874-6223
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Authorized Official
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Title or Position | OWNER
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Name | HUMBERTO M MOLGORA
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Credential | LMT
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Telephone | 786-285-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | MM27802
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License Number State | FL
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