Organization
BACK TO BASIC WELLNESS SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON MARIE VELEZ-MAYMI MD (PRESIDENT/OWNER)
(305) 761-4388
Entity
Organization
Contact information
Practice address
15757 PINES BLVD, SUITE 295, PEMBROKE PINES, FL 33027-1207
(305) 761-4388
Mailing address
15757 PINES BLVD, SUITE 295, PEMBROKE PINES, FL 33027-1207
(305) 761-4388
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/04/2013
Last updated
04/10/2013
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