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Organization
MEDICAL AND WELLNESS CENTER OF MELROSE CORPORATION
Active
Organization
MEDICAL AND WELLNESS CENTER OF MELROSE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KENYETTA LATRICE REESE (PRESIDENT/CEO)
(352) 478-2471
Entity
Organization
Contact information
Practice address
1745 SR 100, MELROSE, FL 32666
(954) 854-4290
Mailing address
1745 SR 100, MELROSE, FL 32666
(352) 478-2471
(352) 478-2496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ACN205
FL
261QH0100X
Health Service Clinic/Center
ARNP780412
FL
Other
Enumeration date
02/11/2009
Last updated
07/16/2014
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