Wondermed of Florida, Inc

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WONDERMED OF FLORIDA, INC

Practice address

828 Crestmoore PL
Venice, CA 90291-4931

Phone

(424) 410-8475

NPI assigned

Dec 16, 2022

Last updated

Dec 16, 2022By 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

Abraham Malkin, MD

Title

President

Phone

(786) 269-5501

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1671148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671148800000",
    "number": "1376255737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 NE 1ST ST FL 8",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331322517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "828 CRESTMOORE PL",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902914931",
            "telephone_number": "424-410-8475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONDERMED OF FLORIDA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-16",
        "last_updated": "2022-12-16",
        "certification_date": "2022-12-16",
        "status": "A",
        "authorized_official_last_name": "MALKIN",
        "authorized_official_first_name": "ABRAHAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-269-5501",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lowell Winer, LMFT
• Susan Winfield, LMFT
• Kristen Branch Winslow, LMFT, MBA
• Wonder Medicine of New York P.C.
• Wondermed of California, Inc
• Wondermed of Texas, P.a.
• Avery Wortham
• Erica Lee Wyatt
• John Michael Yamamoto, D.D.S., M.P.H.
• Candice Yau

• Psychiatry Physician in Venice, CA
• Providers in Venice, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2022; 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.