Organization · Type 2 NPI

The Benjamin Wellness Center South

Specialist · Miami, FL

NPI number 1790155455 Active

Practice location

10300 Sunset Dr, Ste #280
Miami, FL 33173-3012

Fax (305) 901-2189

Specialties and licenses

Taxonomy	Code	License
Specialist Primary	174400000X	None listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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NPI record

NPI: 1790155455
Entity type: Organization (Type 2)
Issued: Oct 6, 2015
Last updated: Oct 6, 2015
Status: Active
Subpart: Yes of Benjamin Outreach Medical Network Corporation

Other names

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Benjamin Outreach Medical Network Corporation · doing business as

Authorized official

Ilnise Mathieu
Director of Operation
(954) 251-0267

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1790155455

The Benjamin Wellness Center South's National Provider Identifier is 1790155455, issued on Oct 6, 2015. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Miami, FL. The record was last updated on Oct 6, 2015.