| Organization Name: | WELLNESS CENTER OF NMB, LLC |
| NPI Number: | 1174710289 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RAYMOND V FAILER (PRESIDENT) |
| Mailing Address: | 1899 Ne 164th St North Miami Beach |
| State: | FL US |
| Postal Code: | 331624109 |
| Phone Number: | 7862741990 |
| Fax Number: | 8886588555 |
| NPI Enumeration Date: | 10/02/2007 |
| NPI Last Update Date: | 03/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS0001920 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |