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Organization

AXIAL MEDICAL CENTER, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WENDY PELEGRIN RN, BSN (ADMINISTRATOR)
(305) 627-5557
Entity
Organization

Contact information

Practice address
5190 NW 167TH ST STE 306, MIAMI LAKES, FL 33014-6338
(305) 627-5557
Mailing address
5190 NW 167TH ST STE 306, MIAMI LAKES, FL 33014-6338
(305) 627-5557

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
103T00000X
Psychologist
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
208D00000X
General Practice Physician

Other

Enumeration date
04/03/2019
Last updated
03/11/2020
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