NPIMap

Organization Active NPI

Life Well Behavioral Health Center, Inc.

Doing business as Life Well Medical Center, Inc.

  • Internal Medicine Physician
  • Doral, FL
National Provider Identifier
1215602743
Registry record updated Aug 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
LIFE WELL BEHAVIORAL HEALTH CENTER, INC.
Doing business as
Life Well Medical Center, Inc.
Practice address
2801 NW 87TH Ave Ste 7
Doral, FL 33172-1604
Phone
(786) 759-8995
NPI assigned
Aug 16, 2021
Last updated
Aug 16, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2021

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

Authorized official

Name
Lianet Gonzalez
Title
Ceo
Phone
(786) 717-6881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

2801 NW 87TH Ave Ste 7
Doral, FL 33172-1604

Mailing address

2801 NW 87TH Ave Ste 7
Doral, FL 33172-1604
Phone (786) 759-8995

Other names 1

  • Life Well Medical Center, Inc. Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Life Well Behavioral Health Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629072000000",
    "number": "1215602743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 NW 87TH AVE STE 7",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331721604",
            "telephone_number": "786-759-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NW 87TH AVE STE 7",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331721604",
            "telephone_number": "786-759-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE WELL BEHAVIORAL HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-16",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "LIANET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "786-717-6881"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Life Well Medical Center, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Doral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.