LIVING WELL MANAGEMENT INC NPI 1134782154

NPI Information

LIVING WELL MANAGEMENT, INC is a clinic center in Fort Lauderdale, FL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). LIVING WELL MANAGEMENT, INC NPI is 1134782154. The provider is registered as an organization entity type.

The provider's business location address is:

3601 W COMMERCIAL BLVD STE 21
FORT LAUDERDALE, FL
ZIP 33309-320
Phone: (954) 909-0407
Fax: (954) 909-0408

The provider's authorized official is Joel Alejo Quintero .
The authorized official title is Ceo and has the following contact phone number (305) 342-8736.

The CLIA number assigned to this NPI record is 10D2165978 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/16/2019 and was last updated on 10/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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