WELLCARE MEDICAL GROUP, LLC (NPI# 1295209757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295209757 |
Entity Type | Organization |
Organization Name | WELLCARE MEDICAL GROUP, LLC |
Practice Address |
327 Lantana Rd Ste Wellcare Lantana FL 33462-1773 |
Practice Telephone | 3523883111 |
Practice Fax Number | 8018818827 |
Mailing Telephone | 3523883111 |
Mailing Fax Number | 8018818827 |
Enumeration Date | 2019-01-17 |
Last Update Date | 2020-07-28 |
Authorized Official Name | WENDI DAVIS (BILLING MANAGER) |
Authorized Official Telephone | 3523883111 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
Street Address |
327 LANTANA RD STE WELLCARE |
City | LANTANA |
State | FL |
Zip Code | 33462-1773 |
NPI | Name | Taxonomy | Address | Enumeration |
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1760024988 | Woodelyne Marc | Home Health | 1307 Flamingo Dr, Lantan, FL 33462 | 2019-10-09 |
1336624428 | Jennifer Lynn Jones | Nurse Practitioner | 5401 S Congress Ave Ste 105, Atlantis, FL 33462 | 2018-09-25 |
1427548445 | Publix Super Markets, Inc. | Pharmacy | 262 S Ocean Blvd, Manalapan, FL 33462 | 2018-05-15 |
1629567474 | Perfection Rx LLC | Pharmacy | 3248 Lantana Rd, Lake Worth, FL 33462 | 2018-05-08 |
1942797824 | Mayra Alejandra Tovar Castro | Student in an Organized Health Care Education/Training Program | 180 Jfk Drive, Suite 210, Atlantis, FL 33462 | 2018-04-17 |
1285131169 | Samar Ibrahim Mohamed Huss Aboulenain | Student in an Organized Health Care Education/Training Program | 180 Jfk Drive, Suite 210, Atlantis, FL 33462 | 2018-04-09 |
1801392535 | Carla Ortega | Student in an Organized Health Care Education/Training Program | 180 Jkf Drive, Suite 210, Atlantis, FL 33462 | 2018-04-02 |
1811427438 | Sonia Camille | Behavior Technician | 49 Sioux Ln, Lantana, FL 33462 | 2017-06-15 |
1922536648 | Alyzza De La Uz Forte | Nurse Practitioner | 180 John F Kennedy Dr, 311, Atlantis, FL 33462 | 2017-05-25 |
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Taxonomy Code | 261QM1300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Multi-Specialty |
Definition to come... |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.