Organization Active NPI

Well-Being Community Center, Corp.

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1114430949
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
WELL-BEING COMMUNITY CENTER, CORP.
Practice address
2706 W St Isabel St
Tampa, FL 33607-6382
Phone
(813) 769-9571
Fax
(813) 492-8843
NPI assigned
Nov 15, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Margarita De la RosaNPI 1770148819
Title
Ceo
Phone
(813) 769-9571

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X
Case Management Agency 251B00000X

Addresses

Primary practice location

2706 W St Isabel St
Tampa, FL 33607-6382

Mailing address

2706 W St Isabel St
Tampa, FL 33607-6382
Phone (813) 769-9571

Other practice location 1

2706 W Saint Isabel St
Tampa, FL 33607-6382
Phone (813) 769-9571 ext. 78631

Other identifiers 7

IdentifierTypeStateIssuer
101692101MedicaidFL
105731200MedicaidFL
105731201MedicaidFL
105430400MedicaidFL
023311300MedicaidFL
105482700MedicaidFL
101692100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190822003896 FL Part B Supplier - Clinic/Group Practice 9133457534 Receives reassigned benefits from 4 practitioners
Practice locations: Tampa, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2181435Well-Being Community Center Corp2706 W Saint Isabel St, Tampa, FL 33607Certificate of waiverApr 2, 2028

National Provider Directory

National Provider Directory

Locations

3414 W 84th St
Ste 100
Hialeah Gardens, FL 33018
Phone (786) 313-3558

2706 W Saint Isabel St
Ste A
Tampa, FL 33607
Phone (813) 870-3665

2706 W Saint Isabel St
Tampa, FL 33607
Phone (813) 769-9571

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1510704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1114430949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 W ST ISABEL ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076382",
            "telephone_number": "813-769-9571",
            "fax_number": "813-492-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2706 W ST ISABEL ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076382",
            "telephone_number": "813-769-9571",
            "fax_number": "813-492-8843"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2706 W Saint Isabel St",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336076382",
            "country_code": "US",
            "telephone_number": "813-769-9571 x78631",
            "fax_number": "813-492-8843",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELL-BEING COMMUNITY CENTER, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-15",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "DE LA ROSA",
        "authorized_official_first_name": "MARGARITA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "813-769-9571",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101692101",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105731200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105731201",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105430400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023311300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105482700",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101692100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.