Provider Demographics
NPI:1710775465
Name:WMT ENTERPISES LLC
Entity type:Organization
Organization Name:WMT ENTERPISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILNELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MEDINA TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:787-621-4828
Mailing Address - Street 1:PO BOX 56004
Mailing Address - Street 2:
Mailing Address - City:BAYAMON
Mailing Address - State:PR
Mailing Address - Zip Code:00960
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CALLE HERNANDEZ CARRION INTERSECCION 668 URB ATENAS
Practice Address - Street 2:
Practice Address - City:MANATI
Practice Address - State:PR
Practice Address - Zip Code:00674-4622
Practice Address - Country:US
Practice Address - Phone:787-621-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty