Provider Demographics
NPI:1730550518
Name:BROWNSVILLE WELLNESS AND REHAB CENTER, LLC
Entity type:Organization
Organization Name:BROWNSVILLE WELLNESS AND REHAB CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:GARICA
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:305-836-2126
Mailing Address - Street 1:7900 NW 27TH AVE # D-11
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4909
Mailing Address - Country:US
Mailing Address - Phone:305-836-2126
Mailing Address - Fax:305-836-2129
Practice Address - Street 1:7900 NW 27TH AVE # D-11
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4909
Practice Address - Country:US
Practice Address - Phone:305-836-2126
Practice Address - Fax:305-836-2129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHCC9659261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center