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NPI Code Detail

MEDICARE: SOCAL WELLNESS INC

MEDICARE: SOCAL WELLNESS 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
1261QH0100XHealth Service Clinic/CenterME 55819FL

General Provider Information

NPI Number : 1932555331
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOCAL WELLNESS INC
Provider Business Mailing Address
First Line : 1028 N FEDERAL HWY STE 100
Second Line :
City : LAKE WORTH
State : FL
Zip : 33460-2352
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1028 N FEDERAL HWY STE 100
Second Line :
City : LAKE WORTH
State : FL
Zip : 33460-2352
Country : US
Telephone Number : 614-203-4646
Fax Number :
Authorized Official
Title or Position : CEO
Name : FRANCO POLICARO
Credential :
Telephone Number : 614-203-4646
Provider Enumeration Date : 05/04/2016
Last Update Date : 05/04/2016

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Directions to “SOCAL WELLNESS INC ” Practice Location

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