Organization
VIRA WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS PROENZA (OWNER)
(954) 669-1125
Entity
Organization
Contact information
Practice address
2429 HOLLYWOOD BLVD STE 300, HOLLYWOOD, FL 33020-6605
(954) 669-1125
(954) 688-7010
Mailing address
2429 HOLLYWOOD BLVD STE 300, HOLLYWOOD, FL 33020-6605
(954) 669-1125
(954) 688-7010
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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