MEDICARE: SWEET START COMMUNITY WELLNESS CENTER INC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251B00000X	Case Management Agency
2	207Q00000X	Family Medicine Physician
3	261Q00000X	Clinic/Center
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0G956	OTHER		MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1528664786
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SWEET START COMMUNITY WELLNESS CENTER INC

Provider Business Mailing Address
First Line	:	5911 NW 173RD DR UNIT 6
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5122
Country	:	US
Telephone Number	:	786-876-5198
Fax Number	:	786-907-4140

Provider Business Practice Location Address
First Line	:	5911 NW 173RD DR STE 5&6
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33015-5121
Country	:	US
Telephone Number	:	786-876-5198
Fax Number	:	786-907-4140

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RAUL SILVA
Credential	:
Telephone Number	:	786-564-5282

Provider Enumeration Date	:	12/11/2020
Last Update Date	:	01/14/2026

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Directions to “SWEET START COMMUNITY WELLNESS CENTER INC ” Practice Location

Language	Start Address	Practice Location

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