Organization
LIVING WELL MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAIRIM GONZALEZ (PRESIDENT)
(786) 216-5570
Entity
Organization
Contact information
Practice address
344 W 65TH ST STE 201, HIALEAH, FL 33012-6719
(786) 216-5570
Mailing address
344 W 65TH ST STE 201, HIALEAH, FL 33012-6719
(786) 216-5570
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
11/06/2018
Last updated
06/06/2022
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