Provider Demographics
NPI:1538406442
Name:WELLINGTON WELLNESS INSTITUTE, LLC
Entity type:Organization
Organization Name:WELLINGTON WELLNESS INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CABANELLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-333-3440
Mailing Address - Street 1:12777 FOREST HILL BLVD STE 1502
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-4775
Mailing Address - Country:US
Mailing Address - Phone:561-333-3440
Mailing Address - Fax:
Practice Address - Street 1:12777 FOREST HILL BLVD STE 1502
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4775
Practice Address - Country:US
Practice Address - Phone:561-333-3440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-11
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83781207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty