Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Heaven Wellness Medical Center, Inc

Organization Clinic/Center · NPI 1053034298

Heaven Wellness Medical Center, Inc is a Clinic/Center in Tampa, Florida. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
4
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

11961 N Florida Ave Ste B
Tampa, FL 33612-5213
Phone: (813) 415-2891
Fax: (813) 443-3149
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X
Health Service Clinic/Center Taxonomy 261QH0100X
Physical Therapy Clinic/Center Taxonomy 261QP2000X
Rehabilitation Clinic/Center Taxonomy 261QR0400X

Record details

NPI number1053034298
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lazara Hurtado Hernandez — Owner · (813) 409-9457
NPI enumeratedSeptember 22, 2022
Last updated in NPPESSeptember 22, 2022
Certification dateSeptember 22, 2022
Mailing addressPo Box 15542, Tampa, FL 33684-5542

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