Provider Demographics
NPI:1144427071
Name:WELLNESS & METABOLIC MEDICAL CENTER, INC
Entity type:Organization
Organization Name:WELLNESS & METABOLIC MEDICAL CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:LEWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-671-8030
Mailing Address - Street 1:150 SE 17TH STREET
Mailing Address - Street 2:SUITE 702
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5159
Mailing Address - Country:US
Mailing Address - Phone:352-671-8030
Mailing Address - Fax:352-671-8031
Practice Address - Street 1:150 SE 17TH ST
Practice Address - Street 2:SUITE 702
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-5178
Practice Address - Country:US
Practice Address - Phone:352-671-8030
Practice Address - Fax:352-671-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0036262261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1487707436OtherNPI NUMBER
FLD70644Medicare UPIN