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General NPI Number Information
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NPI Number | 1922252121
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Entity Type | Organization
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Legal Business Name | WELLINGTON MEDSTAT LLC
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 10/06/2011
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Provider Practice Location Address
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Address Line | 3319 STATE ROAD 7 SUITE 102
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City | WELLINGTON
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State | FL
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Zip | 33449-8094
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Country | US
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Telephone | 561-333-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 3319 SR 7 SUITE 102
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City | WELLINGTON
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State | FL
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Zip | 33449
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Country | US
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Telephone | 561-333-4000
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | DR. BENNY MENENDEZ
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Credential | M.D.
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Telephone | 561-333-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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