NPIMap

Organization Active NPI

MD Family & Wellness, Corp

  • Clinic/Center
  • Port Saint Lucie, FL
National Provider Identifier
1306708698
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MD FAMILY & WELLNESS, CORP
Practice address
5963 NW Baynard Dr
Port Saint Lucie, FL 34986-3604
Phone
(407) 686-2940
Fax
(772) 404-7918
NPI assigned
Nov 25, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Authorized official

Name
Marlevy Dominguez, APRNNPI 1700752599
Title
Ceo
Phone
(407) 686-2940

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

5963 NW Baynard Dr
Port Saint Lucie, FL 34986-3604

Mailing address

5963 NW Baynard Dr
Port Saint Lucie, FL 34986-3604
Phone (407) 686-2940

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1764028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764028800000",
    "number": "1306708698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5963 NW BAYNARD DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863604",
            "telephone_number": "407-686-2940",
            "fax_number": "772-404-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5963 NW BAYNARD DR",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349863604",
            "telephone_number": "407-686-2940",
            "fax_number": "772-404-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD FAMILY & WELLNESS, CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "MARLEVY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-686-2940",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.