Organization
OLYMPUS MEDICAL WELLNESS CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RAUL L DIAZ GIL (AUTHORIZED OFFICIAL)
(786) 872-6133
Entity
Organization
Contact information
Practice address
3611 SW 87TH AVE, MIAMI, FL 33165-4307
(305) 424-7343
(305) 547-9565
Mailing address
468 NW 27TH AVE, MIAMI, FL 33125-3040
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11151515
INS
FL
Enumeration date
09/06/2022
Last updated
01/28/2025
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