Medical and Wellness Center of Melrose Corporation

Organization Active NPI Family Medicine Physician · Melrose, FL

NPI 1770722936 · NPPES record last updated Jul 16, 2014

Key facts

NPI
1770722936
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
ACN205 (FL)
Legal business name
MEDICAL AND WELLNESS CENTER OF MELROSE CORPORATION
Practice address
1745 Sr 100
Melrose, FL 32666
Phone
(954) 854-4290
NPI assigned
Feb 11, 2009
Organization subpart
No

Authorized official

Name
Ms. Kenyetta Latrice Reese
Title
President/Ceo
Phone
(352) 478-2471

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1745 State Road 100
Melrose, FL 32666
Phone (352) 478-2471

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X ACN205 FL Yes
Health Service Clinic/Center 261QH0100X ARNP780412 FL

Addresses

Primary practice location

1745 Sr 100
Melrose, FL 32666

Mailing address

1745 Sr 100
Melrose, FL 32666
Phone (352) 478-2471

Other providers in Melrose, FL

All providers in Melrose, FL · Family Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.