Provider Demographics
NPI:1275426322
Name:WELLNESS LIFE AND COACHING, INC.
Entity type:Organization
Organization Name:WELLNESS LIFE AND COACHING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:IVETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:LLAMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-243-9559
Mailing Address - Street 1:17278 SW 9TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33029-4224
Mailing Address - Country:US
Mailing Address - Phone:954-243-9559
Mailing Address - Fax:
Practice Address - Street 1:1500 W 1ST AVE STE 200
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33327-1006
Practice Address - Country:US
Practice Address - Phone:954-980-1072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-29
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center