Dr Profet Health & Wellness Center LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

DR PROFET HEALTH & WELLNESS CENTER LLC

Practice address

11017 N Dale Mabry Hwy Ste B
Tampa, FL 33618-3873

Phone

(813) 337-7402

Fax

(813) 461-6462

NPI assigned

Jul 10, 2019

Organization subpart

No

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

Authorized official

Name

Mario Profet, MD

Title

Owner

Phone

(305) 984-0697

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1562716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1538711643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11017 N DALE MABRY HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183873",
            "telephone_number": "813-337-7402",
            "fax_number": "813-461-6462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11017 N DALE MABRY HWY STE B",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336183873",
            "telephone_number": "813-337-7402",
            "fax_number": "813-461-6462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR PROFET HEALTH & WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-10",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "PROFET",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-984-0697",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.