South Florida Health and Wellness Center Corp

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SOUTH FLORIDA HEALTH AND WELLNESS CENTER CORP

Practice address

3017 Executive Court
West Palm Beach, FL 33409

Phone

(305) 206-2553

NPI assigned

Mar 10, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Lizet Dibernardo

Title

Ceo

Phone

(954) 732-9817

Specialties & licenses 4

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1750966818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3017 EXCHANGE CT",
            "address_2": "SUITE A-1",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33409",
            "telephone_number": "954-732-9817",
            "fax_number": "561-342-0064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3017 EXECUTIVE COURT",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33409",
            "telephone_number": "305-206-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH FLORIDA HEALTH AND WELLNESS CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-10",
        "last_updated": "2024-02-22",
        "certification_date": "2021-10-27",
        "status": "A",
        "authorized_official_last_name": "DIBERNARDO",
        "authorized_official_first_name": "LIZET",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-732-9817",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "++",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2212 NE 37th St",
            "city": "Lighthouse Point",
            "state": "FL",
            "country_code": "US",
            "postal_code": "330643906",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• South Florida Medical Store Inc
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• Primary Care Clinic/Center in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.