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General NPI Number Information
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NPI Number | 1538406442
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Entity Type | Organization
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Legal Business Name | WELLINGTON WELLNESS INSTITUTE, LLC
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Dates
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Enumeration Date | 01/11/2013
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Last Update Date | 12/12/2022
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Provider Practice Location Address
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Address Line | 12777 FOREST HILL BLVD STE 1502
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City | WELLINGTON
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State | FL
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Zip | 33414-4775
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Country | US
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Telephone | 561-333-3440
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Fax |
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Provider Business Mailing Address
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Address Line | 12777 FOREST HILL BLVD STE 1502
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City | WELLINGTON
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State | FL
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Zip | 33414-4775
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Country | US
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Telephone | 561-333-3440
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. JENNINE MARIE CABANELLAS
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Credential | M.D.
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Telephone | 561-333-3440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME83781
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License Number State | FL
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