Organization Active NPI

Medfamily Wellcare Center Inc

  • Home Health Agency
  • Doral, FL
National Provider Identifier
1790440683
Registry record updated Nov 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MEDFAMILY WELLCARE CENTER INC
Practice address
8725 NW 18TH Ter Ste 312
Doral, FL 33172-2610
Phone
(786) 534-3522
Fax
(786) 590-1713
NPI assigned
Nov 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2021

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

Authorized official

Name
Mr. Orestes Alfonso
Title
Owner
Phone
(305) 926-5023

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

8725 NW 18TH Ter Ste 312
Doral, FL 33172-2610

Mailing address

8725 NW 18TH Ter Ste 312
Doral, FL 33172-2610
Phone (786) 534-3522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220819002852 FL Part A Provider - Home Health Agency 8527441773 Practice locations: Doral, FL

Home health agency certification: CCN 687262

Legal name
MEDFAMILY WELLCARE CENTER INC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 16, 2023
Last certification
May 16, 2023
Organization structure
CorporationProprietary
Incorporated
Feb 8, 2021 in FL
Enrollment address
8725 NW 18TH Ter
Ste 312
Doral, FL 33172-2610
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Medfamily Wellcare Center IncCCN 687262
Ownership
-
Certified
May 16, 2023
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Medfamily Wellcare Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Orestes Alfonso Individual 5% Or Greater Direct Ownership InterestOwner May 8, 2021 100%
Corporate OfficerOwner Feb 8, 2021 100%
W-2 Managing EmployeeOwner Feb 8, 2021 100%
Operational/Managerial ControlOwner Feb 8, 2022 100%

NPI Registry JSON

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636070400000",
    "number": "1790440683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8725 NW 18TH TER STE 312",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722610",
            "telephone_number": "786-534-3522",
            "fax_number": "786-590-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 NW 18TH TER STE 312",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331722610",
            "telephone_number": "786-534-3522",
            "fax_number": "786-590-1713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFAMILY WELLCARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A",
        "authorized_official_last_name": "ALFONSO",
        "authorized_official_first_name": "ORESTES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-926-5023",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.