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Organization
WELLCARE CLINIC INC
Active
Organization
WELLCARE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEYTTIA SARDINAS (PRESIDENT)
(305) 300-6925
Entity
Organization
Contact information
Practice address
11865 SW 26TH ST, B-14, MIAMI, FL 33175-2400
(305) 300-6925
(305) 675-2668
Mailing address
11865 SW 26TH ST, B-14, MIAMI, FL 33175-2400
(305) 300-6925
(305) 675-2668
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
HCC8906
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FILE 9187
AHCA EXEMPT HCC UNIT
FL
Enumeration date
02/16/2011
Last updated
02/16/2011
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