MEDICARE: WELLNESS HEALTH CARE 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	261QP2000X	Physical Therapy Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MM 24830	OTHER	FL	STATE OF FLORIDA

General Provider Information

NPI Number	:	1841511722
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WELLNESS HEALTH CARE INC

Provider Business Mailing Address
First Line	:	4401 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2540
Country	:	US
Telephone Number	:	305-603-7712
Fax Number	:	305-603-8103

Provider Business Practice Location Address
First Line	:	4401 SW 8TH ST
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33134-2540
Country	:	US
Telephone Number	:	305-603-7712
Fax Number	:	305-603-8103

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. EDUARDO BORGES
Credential	:	MR
Telephone Number	:	305-603-7712

Provider Enumeration Date	:	06/15/2010
Last Update Date	:	06/15/2010

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