Organization Active NPI

Wellness Opportunity & Weight Loss Medical Center Inc

  • Psychiatric/Mental Health Nurse Practitioner
  • Coconut Creek, FL
National Provider Identifier
1902795446
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WELLNESS OPPORTUNITY & WEIGHT LOSS MEDICAL CENTER INC
Practice address
3869 NW 62ND CT
Coconut Creek, FL 33073-2129
Phone
(786) 369-6702
NPI assigned
Jun 30, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Authorized official

Name
Julio L CrespoNPI 1700223492
Title
Owner
Phone
(786) 369-6702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

3869 NW 62ND CT
Coconut Creek, FL 33073-2129

Mailing address

3869 NW 62ND CT
Coconut Creek, FL 33073-2129

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250708002788 FL Part B Supplier - Clinic/Group Practice 4587178934 Receives reassigned benefits from 1 practitioner
Practice locations: Coconut Creek, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1902795446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3869 NW 62ND CT",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3869 NW 62ND CT",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330732129",
            "telephone_number": "786-369-6702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLNESS OPPORTUNITY & WEIGHT LOSS MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "CRESPO",
        "authorized_official_first_name": "JULIO",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-369-6702"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; 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.