NPIMap

Organization Active NPI

Wellness Medical Group LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Doral, FL
National Provider Identifier
1760107130
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
WELLNESS MEDICAL GROUP LLC
Practice address
2500 NW 79TH Ave Ste 189
Doral, FL 33122-1083
Phone
(786) 209-0022
NPI assigned
Oct 7, 2022
Organization subpart
Yes
Parent organization
WELLNESS MEDICAL GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Authorized official

Name
Anabel Diaz
Title
Owner
Phone
(305) 746-5424

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2500 NW 79TH Ave Ste 189
Doral, FL 33122-1083

Mailing address

4440 Pga Blvd Ste 410
Palm Beach Gardens, FL 33410-6544
Phone (786) 569-3793

National Provider Directory

National Provider Directory
Tax ID family
Wellness Medical Group LLC3 organizations share this tax ID, including this one
Part of
Wellness Medical Group LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2500 NW 79th Ave
Ste 189
Doral, FL 33122
Phone (786) 209-0022

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1760107130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 PGA BLVD STE 410",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334106544",
            "telephone_number": "786-569-3793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 NW 79TH AVE STE 189",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221083",
            "telephone_number": "786-209-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS MEDICAL GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLNESS MEDICAL GROUP LLC",
        "enumeration_date": "2022-10-07",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "ANABEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-746-5424"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

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