Shalom Wellness Center Corp.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SHALOM WELLNESS CENTER CORP.

Practice address

4995 NW 72ND Ave Ste 209
Miami, FL 33166-5643

Phone

(786) 651-4190

NPI assigned

Sep 18, 2024

Last updated

Sep 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Pedro Luis Jimenez Pulido

Title

Administrator

Phone

(786) 651-4190

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Felipe Peterson, DPM

  • Foot & Ankle Surgery Podiatrist
  • St Petersburg, FL
  • NPI 1033572656
  Medicare reassignment Care Compare group NPD
• Maylin Sanchez, APRN

  • Family Nurse Practitioner
  • Miami, FL
  • NPI 1780236752
  Medicare reassignment Care Compare group NPD
• Karen Romero, LMHC

  • Mental Health Counselor
  • Miami, FL
  • NPI 1275185613
  Medicare reassignment NPD
• Maria Regla Bravo Perez

  • Nurse Practitioner
  • Miami, FL
  • NPI 1821847666
  NPD

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

{
    "created_epoch": "1726617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1205663671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4995 NW 72ND AVE STE 209",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331665643",
            "telephone_number": "786-651-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4995 NW 72ND AVE STE 209",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331665643",
            "telephone_number": "786-651-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHALOM WELLNESS CENTER CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-18",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ PULIDO",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "786-651-4190",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shalom Meidcal Group LLC
• Shalom Psychotherapy Center
• Shalom Psychotherapy Center LLC
• Shalom Psychotherapy Center LLC
• Shalom Rehabilitation Center Inc
• Abraham Shalom
• Shalon Alf
• Micha Yithak Shamir, M.D
• Unknown Shams Ud Din
• Elham Shams, DO

• Mental Health Clinic/Center (Including Community Mental Health Center) in Miami, FL
• Providers in Miami, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.