Organization
FAMILY MEDICAL AND WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANESSA VIZCAINO MD (PRESIDENT)
(561) 721-1953
Entity
Organization
Contact information
Practice address
10111 FOREST HILL BLVD, SUITE 230, WELLINGTON, FL 33414-6108
(561) 721-1953
(561) 721-2257
Mailing address
10111 FOREST HILL BLVD, SUITE 230, WELLINGTON, FL 33414-6108
(561) 721-1953
(561) 721-2257
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME 87499
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295797140
NPI
FL
01
—
1730140211
NPI
FL
Enumeration date
02/26/2008
Last updated
06/08/2012
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