Organization
NEW IDENTITY WELLNESS CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARIDAD HAYES (OFFICER)
(954) 589-1971
Entity
Organization
Contact information
Practice address
14601 SW 29TH ST STE 107, MIRAMAR, FL 33027-4715
(786) 804-9405
Mailing address
14601 SW 29TH ST STE 107, MIRAMAR, FL 33027-4715
(954) 589-1971
(305) 317-4453
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/20/2020
Last updated
10/09/2025
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