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General NPI Number Information
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NPI Number | 1992256572
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Entity Type | Organization
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Legal Business Name | WELLNESS DIAGNOSTIC CENTER INC
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Dates
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Enumeration Date | 10/19/2016
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Last Update Date | 06/18/2024
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Provider Practice Location Address
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Address Line | 7175 SW 8TH ST STE 214
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City | MIAMI
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State | FL
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Zip | 33144-4674
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Country | US
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Telephone | 305-456-6055
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Fax | 786-431-3126
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Provider Business Mailing Address
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Address Line | 7175 SW 8TH ST SUITE 212
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City | MIAMI
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State | FL
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Zip | 33144-4676
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Country | US
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Telephone | 305-456-6055
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Fax | 786-360-6232
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Authorized Official
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Title or Position | OWNER
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Name | YULEXIS RODRIGUEZ PORTAL
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Credential |
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Telephone | 305-456-6055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | ME86719
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2471S1302X
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Taxonomy Name | Sonography Radiologic Technologist
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License Number | ARDMS142041
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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