| Living Water Wellness Center, Llc | |
|
2400 E Commercial Blvd Ste 218 Ft Lauderdale FL 33308-4022 | |
| (305) 334-6163 | |
| (786) 513-3811 |
| Full Name | Living Water Wellness Center, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2400 E Commercial Blvd Ste 218, Ft Lauderdale, Florida |
| Authorized Official Name and Position | Alejandro Perez (PROVIDER MANAGER) |
| Authorized Official Contact | 3059053042 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Living Water Wellness Center, Llc 13762 W State Road 84 # 95 Davie FL 33325-5305 Ph: (305) 334-6163 | Living Water Wellness Center, Llc 2400 E Commercial Blvd Ste 218 Ft Lauderdale FL 33308-4022 Ph: (305) 334-6163 |
| NPI Number | 1134991177 |
|---|---|
| Provider Enumeration Date | 10/24/2023 |
| Last Update Date | 10/28/2025 |
| Medicare PECOS PAC ID | 3577901529 |
|---|---|
| Medicare Enrollment ID | O20240409004860 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134991177 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Alejandro Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407256480 PECOS PAC ID: 2668798943 Enrollment ID: I20150304000484 |
| Provider Name | Ernesto Garcia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205591096 PECOS PAC ID: 3577953504 Enrollment ID: I20211207001585 |
| Provider Name | Malena Munoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497420509 PECOS PAC ID: 0749671790 Enrollment ID: I20211229001943 |
| Provider Name | Ronyd Sanchez Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376306530 PECOS PAC ID: 3678919511 Enrollment ID: I20240313003042 |
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