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General NPI Number Information
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NPI Number | 1639511306
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Entity Type | Organization
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Legal Business Name | HEALTH & WELLNESS CENTER OF MIAMI INC.
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Dates
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Enumeration Date | 07/23/2013
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 20555 OLD CUTLER RD
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City | CUTLER BAY
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State | FL
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Zip | 33189-2455
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Country | US
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Telephone | 305-233-4325
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Fax |
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Provider Business Mailing Address
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Address Line | 20555 OLD CUTLER RD
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City | CUTLER BAY
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State | FL
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Zip | 33189-2455
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Country | US
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Telephone | 305-233-4325
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. RUSSELL ROGG
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Credential | AP.OMD.
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Telephone | 305-251-4325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | AP000283
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License Number State | FL
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