MEDICARE: PERFECT WELLNESS CENTER, INC

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	261Q00000X	Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487227252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERFECT WELLNESS CENTER, INC

Provider Business Mailing Address
First Line	:	19100 SW 106TH AVE UNIT 12
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7643
Country	:	US
Telephone Number	:	305-395-0281
Fax Number	:

Provider Business Practice Location Address
First Line	:	19100 SW 106TH AVE UNIT 12
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33157-7643
Country	:	US
Telephone Number	:	305-395-0281
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ALBERTO MARTINEZ MEDINA
Credential	:
Telephone Number	:	305-395-0281

Provider Enumeration Date	:	07/20/2021
Last Update Date	:	07/20/2021

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