Organization
WHEAT COMMUNITY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REGINA COOPER (DIRECTOR)
(954) 661-7227
Entity
Organization
Contact information
Practice address
2627 NE 203RD ST STE 109, MIAMI, FL 33180-1945
(305) 682-8700
(305) 682-8994
Mailing address
2627 NE 203RD ST STE 109, SUITE 109, AVENTURA, FL 33180-1945
(305) 682-8700
(305) 682-8994
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10-443
DOH TESTING SITE
FL
01
—
10D2181154
CLIA - SITE BASED AND MOBILE
FL
01
—
10D2181356
CLIA
FL
01
—
13-64-2027757
BIOMEDICAL WASTE
FL
01
—
6011757
DPBR - HCCE
FL
01
—
E063187
E15 - LIFE AND HEALTH INSURANCE
FL
Enumeration date
05/21/2020
Last updated
10/18/2025
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