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General NPI Number Information
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NPI Number | 1962756650
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Entity Type | Organization
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Legal Business Name | WEMIND INSTITUTE P.A,
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Dates
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Enumeration Date | 11/01/2012
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 1695 NW 110TH AVE STE 317
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City | MIAMI
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State | FL
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Zip | 33172-1930
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Country | US
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Telephone | 305-671-3654
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Fax | 305-459-3242
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Provider Business Mailing Address
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Address Line | 1695 NW 110TH AVE STE 317
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City | MIAMI
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State | FL
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Zip | 33172-1930
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Country | US
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Telephone | 305-671-3654
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Fax | 305-459-3242
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Authorized Official
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Title or Position | OWNER
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Name | MRS. ELZA VASCONCELLOS
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Credential | M.D.
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Telephone | 305-671-3654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | ME77405
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License Number State | FL
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