Organization
PRIMARY WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE R PEREZ LMT (PRESIDENT)
(305) 982-8471
Entity
Organization
Contact information
Practice address
6445 SW 8TH ST, WEST MIAMI, FL 33144-4813
(305) 982-8471
(305) 982-8572
Mailing address
6445 SW 8TH ST, WEST MIAMI, FL 33144-4813
(305) 982-8471
(305) 982-8572
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
HCC9174
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HCC9174
AHCA CERTIFICATION
FL
Enumeration date
06/03/2011
Last updated
06/03/2011
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