MEDICAL AND WELLNESS CENTER OF MELROSE CORPORATION (NPI# 1770722936) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770722936 |
| Entity Type | Organization |
| Organization Name | MEDICAL AND WELLNESS CENTER OF MELROSE CORPORATION |
| Practice Address |
1745 Sr 100 Melrose FL 32666 |
| Practice Telephone | 9548544290 |
| Mailing Telephone | 3524782471 |
| Mailing Fax Number | 3524782496 |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2014-07-16 |
| Authorized Official Name | MS. KENYETTA LATRICE REESE (PRESIDENT/CEO) |
| Authorized Official Telephone | 3524782471 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
ARNP780412 | FL | Ambulatory Health Care Facilities |
| Y | 207Q00000X | Family Medicine | ACN205 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
1745 SR 100 |
| City | MELROSE |
| State | FL |
| Zip Code | 32666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487166021 | Sandra June Northway | Nurse Practitioner | 1326 Fl-100 Melrose, Fl 32666, Melrose, FL 32666 | 2017-11-03 |
| 1477932408 | Eswt Inc | Specialist | 671 Se 5th Avenue, Box 91, Melrose, FL 32666 | 2015-05-22 |
| 1598987786 | Jeffrey C Smith | Dentist | 100 S R 26, Melrose, FL 32666 | 2007-05-03 |
| 1558491555 | Elisa Neale-tobener | Speech-Language Pathologist | 861 Hwy 21, Melrose, FL 32666 | 2007-03-07 |
| 1649280785 | Laura S Hodges | Physical Therapist | 25727 Ne Sr 26, Melrose, FL 32666 | 2006-08-09 |
| 1376682518 | Lake Area Physical Therapy Inc | Occupational Therapist | 25727 Ne State Rd 26, Melrose, FL 32666-1099 | 2007-02-05 |
| 1417150905 | Richard C Sturdivant | Specialist | 123 1st St, Melrose, FL 32666-3030 | 2007-06-11 |
| 1194104414 | Anne Wister | Specialist | 102 Serenity Dr, Melrose, FL 32666-3032 | 2015-05-19 |
| 1609033646 | Canaide Inc | Supports Brokerage | 723 State Road 26, Melrose, FL 32666-3139 | 2008-05-19 |
| 1831230564 | Delcora Howell | Nurse Practitioner | 1745 State Road 100, Melrose, FL 32666-3146 | 2007-02-08 |
| Find all providers in zip 32666 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033224688 | David M. Wahl, Md | Family Medicine | 31 Geneva Rd, Melrose, MA 02176-4001 | 2006-08-21 |
| 1376505222 | Gloria Moussa-gabour | Family Medicine | 20 E Emerson St, Melrose, MA 02176-3521 | 2006-04-05 |
| 1083698286 | James A Mohs | Family Medicine | 525 W Main, Centracare Clinic, Melrose, MN 56352 | 2005-12-01 |
| 1770564833 | Dante Carl Beretta | Family Medicine | 525 Main St W, Centracare Health System - Melrose, Melrose, MN 56352-1043 | 2005-11-07 |
| 1700220712 | Michael Jon Beste | Family Medicine | 525 Main St W, Melrose, MN 56352-1043 | 2013-04-21 |
| 1306134812 | Massachusetts Acute Care Specialists PC | Family Medicine | 585 Lebanon St, Melrose, MA 02176-3225 | 2011-07-18 |
| 1952425001 | Ciriaco A Borroto | Family Medicine | 1745 State Road 100, Melrose, FL 32666-3146 | 2007-03-16 |
| 1215067913 | David A Calef | Family Medicine | 50 Rowe St, Suite 200, Melrose, MA 02176 | 2007-03-06 |
| 1306989066 | Timothy A Tierney | Family Medicine | 675 Main St, Melrose, MA 02176-3138 | 2007-02-14 |
| 1528125119 | Clara A Lennox | Family Medicine | 35 Green St, Melrose, MA 02176 | 2007-01-02 |
| Find all providers in MELROSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.