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General NPI Number Information
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NPI Number | 1750822557
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Entity Type | Organization
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Legal Business Name | HOMESTEAD HEALTH AND WELLNESS CENTER INC
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 05/21/2020
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Provider Practice Location Address
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Address Line | 125 NE 8TH ST SUITE 4
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City | HOMESTEAD
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State | FL
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Zip | 33030-4676
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Country | US
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Telephone | 305-247-8585
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Fax | 305-246-8109
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Provider Business Mailing Address
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Address Line | 9780 E INDIGO ST SUITE 202
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City | PALMETTO BAY
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State | FL
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Zip | 33157-5609
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Country | US
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Telephone | 305-252-9485
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Fax | 305-252-9486
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. RAYMOND LEVY
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Credential |
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Telephone | 305-252-9485
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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