| Dwellness Lab Corp | |
|
4105 E 4th Ave Ste 2d Hialeah FL 33013-2318 | |
| (305) 419-2679 | |
| (786) 931-2388 |
| Full Name | Dwellness Lab Corp |
|---|---|
| Speciality | Family Medicine |
| Location | 4105 E 4th Ave Ste 2d, Hialeah, Florida |
| Authorized Official Name and Position | Raul Rodriguez (CEO) |
| Authorized Official Contact | 3058772870 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dwellness Lab Corp 4105 E 4th Ave Ste 2d Hialeah FL 33013-2318 Ph: (305) 419-2679 | Dwellness Lab Corp 4105 E 4th Ave Ste 2d Hialeah FL 33013-2318 Ph: (305) 419-2679 |
| NPI Number | 1689559551 |
|---|---|
| Provider Enumeration Date | 08/08/2025 |
| Last Update Date | 07/10/2026 |
| Certification Date | 07/10/2026 |
| Medicare PECOS PAC ID | 1456844463 |
|---|---|
| Medicare Enrollment ID | O20251208000029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689559551 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 261Q00000X | Clinic/center | () | Secondary |
| Provider Name | Fernando E Melgar Somoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447882907 PECOS PAC ID: 4183052921 Enrollment ID: I20200310001560 |
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