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Organization
MWL-PB-BR-LLC
Active
Organization
MWL-PB-BR-LLC
Active
Other names
Medi Weightloss
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELISSA SOMMERVILLE (OWNER)
(407) 383-3848
Entity
Organization
Contact information
Practice address
2466 E COMMERCIAL BLVD STE 101, FORT LAUDERDALE, FL 33308-4011
(754) 216-7177
Mailing address
2466 E COMMERCIAL BLVD STE 101, FORT LAUDERDALE, FL 33308-4011
(754) 216-7177
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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