MEDICARE: WELLMAX MEDICAL CENTERS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1477005262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLMAX MEDICAL CENTERS LLC

Provider Business Mailing Address
First Line	:	9250 W FLAGLER ST STE 600
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-3460
Country	:	US
Telephone Number	:	305-448-8100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1422 NW 7TH ST
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3700
Country	:	US
Telephone Number	:	305-631-8080
Fax Number	:	305-631-8030

Authorized Official
Title or Position	:	DIR PRACTICE MANAGEMENT
Name	:	MISS VANESSA VILLALI
Credential	:
Telephone Number	:	305-586-7288

Provider Enumeration Date	:	10/27/2016
Last Update Date	:	09/16/2024

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