| Organization Name: | WELLNESS MEDICAL CLINIC AND GERIATRIC CENTER INC |
| NPI Number: | 1033395041 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | YAVIR M. ESCOVAR (PHYSICIAN) |
| Mailing Address: | 12741 Miramar Pkwy Building 2, Suite 104 Miramar |
| State: | FL US |
| Postal Code: | 330272903 |
| Phone Number: | 9543929993 |
| Fax Number: | 9543925559 |
| NPI Enumeration Date: | 01/21/2008 |
| NPI Last Update Date: | 11/30/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | ME73704 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |