Organization
MYCLINIC WELLNESS CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAFAEL A. UBEDA M.D. (PRESIDENT)
(305) 902-8137
Entity
Organization
Contact information
Practice address
14201 SW 120TH ST STE 210, MIAMI, FL 33186-7663
(305) 902-8137
Mailing address
14201 SW 120TH ST STE 210, MIAMI, FL 33186-7663
(305) 902-8137
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
05/19/2021
Last updated
05/19/2021
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