Heal Alive Preventive and Wellness Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HEAL ALIVE PREVENTIVE AND WELLNESS INC

Practice address

4501 Palm Ave Ste 206
Hialeah, FL 33012-4076

Phone

(786) 200-0655

NPI assigned

Aug 16, 2024

Organization subpart

No

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

Authorized official

Name

Evilio A Prendes, APRNNPI 1689900334

Title

President

Phone

(786) 200-0655

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• Evilio A Prendes, APRN

  • Family Nurse Practitioner
  • Doral, FL
  • NPI 1689900334
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723766400000",
    "number": "1871325936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4501 PALM AVE STE 206",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124076",
            "telephone_number": "786-200-0655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4501 PALM AVE STE 206",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330124076",
            "telephone_number": "786-200-0655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAL ALIVE PREVENTIVE AND WELLNESS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A",
        "authorized_official_last_name": "PRENDES",
        "authorized_official_first_name": "EVILIO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-200-0655",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Hialeah, FL
• Providers in Hialeah, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.