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General NPI Number Information
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NPI Number | 1487452546
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Entity Type | Organization
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Legal Business Name | EXCELLENCE WELLNESS CARE
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 04/02/2025
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Provider Practice Location Address
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Address Line | 1840 W 49TH ST STE 728
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City | HIALEAH
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State | FL
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Zip | 33012-2973
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Country | US
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Telephone | 786-873-7843
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Fax |
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Provider Business Mailing Address
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Address Line | 1840 W 49TH ST STE 728
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City | HIALEAH
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State | FL
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Zip | 33012-2973
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Country | US
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Telephone | 786-873-7843
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NOEMI MENDEZ HERNANDEZ
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Credential | ARPN
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Telephone | 786-873-7843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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