MEDICARE: MPOWER WELLNESS 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1801580113
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MPOWER WELLNESS LLC

Provider Business Mailing Address
First Line	:	22807 SW 89TH PATH
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1367
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	22807 SW 89TH PATH
Second Line	:
City	:	CUTLER BAY
State	:	FL
Zip	:	33190-1367
Country	:	US
Telephone Number	:	786-412-0637
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CELESTE MARIN
Credential	:
Telephone Number	:	786-412-0637

Provider Enumeration Date	:	06/08/2023
Last Update Date	:	06/08/2023

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Directions to “MPOWER WELLNESS LLC ” Practice Location

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