Provider Demographics
NPI:1609673532
Name:FENIX WELLNESS, LLC
Entity type:Organization
Organization Name:FENIX WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:ADANYS
Authorized Official - Middle Name:
Authorized Official - Last Name:ALONSO-ALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-998-7885
Mailing Address - Street 1:15190 SW 136TH ST STE 26-27
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33196-2604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8370 W FLAGLER ST STE 252
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-2040
Practice Address - Country:US
Practice Address - Phone:786-378-5801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FENIX WELLNESS,LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-27
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty