Organization Active NPI

Life Wellness Center Inc

  • Exclusive Provider Organization
  • Coral Gables, FL
National Provider Identifier
1962675702
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
PY5490 Issued in FL
Legal business name
LIFE WELLNESS CENTER INC
Practice address
3119 Coral Way
Suite 200
Coral Gables, FL 33145-3209
Phone
(305) 525-3629
Fax
(305) 969-1521
NPI assigned
Apr 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Gerardo Francisco Rodriguez-Menendez, PH.D.
Title
President
Phone
(305) 525-3629

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X PY5490 FL Primary

Addresses

Primary practice location

3119 Coral Way
Suite 200
Coral Gables, FL 33145-3209

Mailing address

3119 Coral Way
Suite 200
Coral Gables, FL 33145-3209
Phone (305) 525-3629

National Provider Directory

National Provider Directory

Locations

3119 Coral Way
Ste 200
Miami, FL 33145
Phone (305) 441-8202

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": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1962675702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3119 CORAL WAY",
            "address_2": "SUITE 200",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331453209",
            "telephone_number": "305-525-3629",
            "fax_number": "305-969-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3119 CORAL WAY",
            "address_2": "SUITE 200",
            "city": "CORAL GABLES",
            "state": "FL",
            "postal_code": "331453209",
            "telephone_number": "305-525-3629",
            "fax_number": "305-969-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ-MENENDEZ",
        "authorized_official_first_name": "GERARDO",
        "authorized_official_middle_name": "FRANCISCO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "305-525-3629",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "FL",
            "license": "PY5490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Gables, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.