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Organization

DATE WELLNESS CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JESSICA KELNER MD (MEDICAL DIRECTOR)
(305) 974-5683
Entity
Organization

Contact information

Practice address
5190 NW 167TH ST, STE 308, MIAMI LAKES, FL 33014-6328
(305) 974-5683
(305) 646-1361
Mailing address
5190 NW 167TH ST, STE 308, MIAMI LAKES, FL 33014-6328
(305) 974-5683
(305) 646-1361

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
OS12303
FL

Other

Enumeration date
09/24/2014
Last updated
09/24/2014
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