Active NPI
Medfamily Wellcare Center Inc
- Home Health Agency
- Doral, FL
National Provider Identifier
1790440683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Corporation
- Incorporated
- Feb 8, 2021 in FL
- Enrollment address
- 8725 NW 18TH Ter
Ste 312
Doral, FL 33172-2610
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Medfamily Wellcare Center Inc
- Ownership
- -
- Certified
- May 16, 2023
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Medfamily Wellcare Center Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Doral, FL
- NPI 1124612239
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.
| Name | Role | Since | Share |
|---|---|---|---|
| Orestes Alfonso | 5% Or Greater Direct Ownership Interest | May 8, 2021 | 100% |
| Corporate Officer | Feb 8, 2021 | 100% | |
| W-2 Managing Employee | Feb 8, 2021 | 100% | |
| Operational/Managerial Control | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.