Provider Demographics
NPI:1285225730
Name:WELLMAX HEALTH MEDICAL CENTERS, LLC
Entity type:Organization
Organization Name:WELLMAX HEALTH MEDICAL CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR. PRACTIC MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-586-7288
Mailing Address - Street 1:9250 W FLAGLER ST STE 600
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33174-3460
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2601 S MILITARY TRL # 100
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-7510
Practice Address - Country:US
Practice Address - Phone:855-935-5629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WELLMAX HEALTH MEDICAL CENTERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-28
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty