Provider Demographics
NPI:1902171812
Name:MEDIGLEZ WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:MEDIGLEZ WELLNESS CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IDEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARMENTEROS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-615-4431
Mailing Address - Street 1:8370 W FLAGLER ST
Mailing Address - Street 2:SUITE 244
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144
Mailing Address - Country:US
Mailing Address - Phone:786-615-4431
Mailing Address - Fax:786-615-2657
Practice Address - Street 1:8370 W FLAGLER ST
Practice Address - Street 2:SUITE 244
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144
Practice Address - Country:US
Practice Address - Phone:786-615-4431
Practice Address - Fax:786-615-2657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC6318261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service