MEDICARE: COMMUNITY HEALTH AND WELLNESS CENTER OF MIAMI

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	2084P0800X	Psychiatry Physician
3	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1962938928
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY HEALTH AND WELLNESS CENTER OF MIAMI

Provider Business Mailing Address
First Line	:	1671 W 37TH ST
Second Line	:	STE 4
City	:	HIALEAH
State	:	FL
Zip	:	33012-4639
Country	:	US
Telephone Number	:	305-729-4880
Fax Number	:	305-390-0084

Provider Business Practice Location Address
First Line	:	759 NW 22ND AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33125-3339
Country	:	US
Telephone Number	:	305-541-5245
Fax Number	:	305-649-0496

Authorized Official
Title or Position	:	CEO
Name	:	MASIEL MOREIRA
Credential	:
Telephone Number	:	786-515-3156

Provider Enumeration Date	:	05/11/2017
Last Update Date	:	04/04/2022

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Directions to “COMMUNITY HEALTH AND WELLNESS CENTER OF MIAMI ” Practice Location

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