NPIMap

Organization Active NPI

MD and Wellness Center Inc

  • Primary Care Clinic/Center
  • Tampa, FL
National Provider Identifier
1922342906
Registry record updated Mar 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MD AND WELLNESS CENTER INC
Practice address
4730 N Habana Ave Ste 300
Tampa, FL 33614-7148
Phone
(813) 876-7700
Fax
(813) 876-8700
NPI assigned
Nov 15, 2012
Last updated
Mar 23, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2022

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

Authorized official

Name
Dr. Jose Luis Cruz, MDNPI 1841230240
Title
President/Medical Director
Phone
(813) 876-7700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207K00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

4730 N Habana Ave Ste 300
Tampa, FL 33614-7148

Mailing address

2541 N Dale Mabry Hwy Unit 413
Tampa, FL 33607-2408
Phone (813) 876-7700

Other identifiers 2

IdentifierTypeStateIssuer
003245000MedicaidFL
280564200MedicaidFL

National Provider Directory

National Provider Directory

Locations

4600 N Habana Ave
Ste 12
Tampa, FL 33614
Phone (813) 872-2913

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647993600000",
    "number": "1922342906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2541 N DALE MABRY HWY UNIT 413",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336072408",
            "telephone_number": "813-876-7700",
            "fax_number": "813-876-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 N HABANA AVE STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147148",
            "telephone_number": "813-876-7700",
            "fax_number": "813-876-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD AND WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2022-03-23",
        "certification_date": "2022-03-23",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-876-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003245000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280564200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.