| Midland Wellness Centers | |
|
1421 E Oakland Park Blvd Ste 200 Oakland Park FL 33334-4434 | |
| (954) 565-0875 | |
| (954) 565-0876 |
| Full Name | Midland Wellness Centers |
|---|---|
| Speciality | Family Medicine |
| Location | 1421 E Oakland Park Blvd Ste 200, Oakland Park, Florida |
| Authorized Official Name and Position | Noah J Lee (DIRECTOR) |
| Authorized Official Contact | 9545650875 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midland Wellness Centers 1421 E Oakland Park Blvd Ste 200 Oakland Park FL 33334-4434 Ph: (954) 565-0875 | Midland Wellness Centers 1421 E Oakland Park Blvd Ste 200 Oakland Park FL 33334-4434 Ph: (954) 565-0875 |
| NPI Number | 1447305339 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 09/05/2023 |
| Certification Date | 09/05/2023 |
| Medicare PECOS PAC ID | 3274638549 |
|---|---|
| Medicare Enrollment ID | O20070414000063 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447305339 | NPI | - | NPPES |
| 97941 | Other | FL | BCBS |
| 170442 | Other | FL | HUMANA |
| 7258838 | Other | FL | AETNA |
| 2342763 | Other | FL | AETNA HMO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS9305 (Florida) | Primary |
| Provider Name | John R Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265403570 PECOS PAC ID: 7810092186 Enrollment ID: I20070414000067 |
| Provider Name | Noah J Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275559106 PECOS PAC ID: 8729183090 Enrollment ID: I20070414000068 |
| Provider Name | Bruna P Purgato Dantas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871915645 PECOS PAC ID: 8921321555 Enrollment ID: I20150106001435 |
| Provider Name | Joshua K Fowler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063821759 PECOS PAC ID: 6901188234 Enrollment ID: I20170123001224 |
| Provider Name | Timothy W Mcdowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972704765 PECOS PAC ID: 7416056783 Enrollment ID: I20190410001405 |
| Provider Name | Steve Lizano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972107878 PECOS PAC ID: 0840601605 Enrollment ID: I20201130001531 |
| Provider Name | Steven M Cardenas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376212050 PECOS PAC ID: 9032517602 Enrollment ID: I20211012002527 |
| Provider Name | Mark David Kinkel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952185894 PECOS PAC ID: 6901252972 Enrollment ID: I20231026003525 |
| Provider Name | Roxanne Ramona Bromfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598534406 PECOS PAC ID: 0547611386 Enrollment ID: I20240105003176 |
| Provider Name | Fabian Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659185460 PECOS PAC ID: 6406378223 Enrollment ID: I20250320002253 |
| Provider Name | Ankit Kumar Srivastava |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225787955 PECOS PAC ID: 2365961257 Enrollment ID: I20250523000201 |
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