Wellcare Medical Clinic LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS10509 Issued in FL

Legal business name

WELLCARE MEDICAL CLINIC LLC

Practice address

2901 Coral Hills Drive
Suite 250
Coral Springs, FL 33065-4146

Phone

(954) 603-5508

NPI assigned

Feb 10, 2011

Last updated

Feb 10, 2011By 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

Dr. Simon C Wong, D.O..,M.B.A.,M.M.NPI 1548411457

Title

President

Phone

(954) 383-4262

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

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.

• Simon CHI-Hin Wong, D.O., M.B.A., M.M.

  • Internal Medicine Physician
  • Coral Springs, FL
  • NPI 1548411457
  Medicare reassignment NPD Authorized official
• Jiajing Zheng, ANCC

  • Family Nurse Practitioner
  • Coral Springs, FL
  • NPI 1720971062
  NPD (past)

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

{
    "created_epoch": "1297296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297296000000",
    "number": "1730485616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 CORAL HILLS DRIVE",
            "address_2": "SUITE 250",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654146",
            "telephone_number": "954-603-5508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 CORAL HILLS DRIVE",
            "address_2": "SUITE 250",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330654146",
            "telephone_number": "954-603-5508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLCARE MEDICAL CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-10",
        "last_updated": "2011-02-10",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "SIMON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-383-4262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O..,M.B.A.,M.M."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS10509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margo Florence Weiss, PH.D.
• Stephanie H Weiss, OTR
• Steven Weiss, M.D.
• Mark Eli Weissman, D.D.S.
• Ashley Welker
• Janet R Welles, LMHC
• Wellington Counseling & Associates Inc (Elevations Health)
• Wellington Counseling & Associates Inc
• Noah Wellington
• Andrew Joseph Wenger, DC

• Internal Medicine Physician in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2011; 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.