Organization
DIAMOND WELLNESS & MED CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA PATRICIA PEREZ -PENA (MGR)
(786) 439-6017
Entity
Organization
Contact information
Practice address
1470 NW 107TH AVE STE M, SWEETWATER, FL 33172-2735
(786) 439-6017
Mailing address
1470 NW 107TH AVE STE M, SWEETWATER, FL 33172-2735
(786) 439-6017
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QP1100X
Podiatric Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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