Organization · NPI-2

A&C Wellness LLC

Family Medicine · Hialeah, FL

NPI number1669067344
StatusActive
Last updated in NPPESMar 5, 2021

Details

NPI
1669067344
Entity type
Organization (NPI-2)
Legal business name
A&C Wellness LLC
Organization subpart
No
Enumeration date
Mar 4, 2021
Certification date
Mar 5, 2021
Last updated
Mar 5, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes
363LF0000X Nurse Practitioner, Family––

Practice location

1748 W 56th Ter Unit 410
Hialeah, FL 33012-2006

Phone 786-319-8826

Mailing address

1748 W 56th Ter Unit 410
Hialeah, FL 33012-2006

Phone 786-319-8826

Authorized official

Carmen M Perez Santamaria
Manager
7869753069

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