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Organization
USA WELLNESS PROVIDERS CORP
Active
Organization
USA WELLNESS PROVIDERS CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELO CORREA (PRESIDENT/CEO)
(678) 683-2223
Entity
Organization
Contact information
Practice address
1050 LEE WAGENER BLVD, 230, FORT LAUDERDALE, FL 33315-3500
(678) 683-2223
Mailing address
1050 LEE WAGENER BLVD, 230, FORT LAUDERDALE, FL 33315-3500
(678) 683-2223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GZ379A
MEDICARE PART B
—
Enumeration date
04/25/2013
Last updated
04/25/2013
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