Diamond Wellness & Med Center LLC – Clinic/Center

Key facts

NPI: 1124839618
Entity type: Organization (NPI type 2)
Primary specialty: Clinic/Center 261Q00000X
Legal business name: DIAMOND WELLNESS & MED CENTER LLC
Practice address: 1470 NW 107TH Ave Ste M
Sweetwater, FL 33172-2735
Phone: (786) 439-6017
NPI assigned: Jan 15, 2025
Organization subpart: No

Authorized official

Name: Monica Patricia Perez -Pena NPI 1801241443
Title: MGR
Phone: (786) 439-6017

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

Practitioners 1

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

Monica Patricia Perez-Pena Massage Therapist · Miami, FL · NPI 1801241443

NPD Authorized official

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	Primary
Sports Medicine (Family Medicine) Physician Group: 193200000X MULTI-SPECIALTY GROUP	207QS0010X
Clinic/Center	261Q00000X	Yes
Infusion Therapy Clinic/Center	261QI0500X
Podiatric Clinic/Center	261QP1100X
Physical Therapy Clinic/Center	261QP2000X
Rehabilitation Clinic/Center	261QR0400X
Comprehensive Outpatient Rehabilitation Facility (CORF)	261QR0401X

Addresses

Primary practice location

1470 NW 107TH Ave Ste M
Sweetwater, FL 33172-2735

Mailing address

1470 NW 107TH Ave Ste M
Sweetwater, FL 33172-2735
Phone (786) 439-6017

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 15, 2025.

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1124839618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1470 NW 107TH AVE STE M",
            "city": "SWEETWATER",
            "state": "FL",
            "postal_code": "331722735",
            "telephone_number": "786-439-6017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1470 NW 107TH AVE STE M",
            "city": "SWEETWATER",
            "state": "FL",
            "postal_code": "331722735",
            "telephone_number": "786-439-6017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND WELLNESS & MED CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "PEREZ -PENA",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "PATRICIA",
        "authorized_official_title_or_position": "MGR",
        "authorized_official_telephone_number": "786-439-6017"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sweetwater, FL

All providers in Sweetwater, FL · Clinic/Center in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 15, 2025. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.