| Wellness360 Primary Care | |
| 
					1700 Se Hillmoor Dr Ste 305 Port Saint Lucie FL 34952-7536  | |
| (772) 292-8188 | |
| Not Available | 
| Full Name | Wellness360 Primary Care | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 1700 Se Hillmoor Dr Ste 305, Port Saint Lucie, Florida | 
| Authorized Official Name and Position | Yohanna Deno (OWNER) | 
| Authorized Official Contact | 7646702685 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Wellness360 Primary Care 1700 Se Hillmoor Dr Ste 305 Port Saint Lucie FL 34952-7536 Ph: () -  | Wellness360 Primary Care 1700 Se Hillmoor Dr Ste 305 Port Saint Lucie FL 34952-7536 Ph: (772) 292-8188  | 
| NPI Number | 1154172773 | 
|---|---|
| Provider Enumeration Date | 04/01/2024 | 
| Last Update Date | 04/01/2024 | 
| Medicare PECOS PAC ID | 1052751674 | 
|---|---|
| Medicare Enrollment ID | O20240430002706 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1154172773 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary | 
| Provider Name | Yohanna Deno | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1700050275 PECOS PAC ID: 4284805805 Enrollment ID: I20131009000276  | 
| Provider Name | Massiel Morales | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1942823067 PECOS PAC ID: 9234545666 Enrollment ID: I20210310001474  | 
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