OrganizationActive
Southeast Wellness Lane Corp
NPI 1962962316 · Internal Medicine Physician · Davie, FL
Provider details
- NPI number
- 1962962316
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Yuri Salas Espinosa, President(786) 493-2293
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(66/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
13265 Sw 39th St
Davie, FL 33330-4748
Phone: (786) 493-2293
Street-level locationGet directions
Mailing address
13265 Sw 39th St
Davie, FL 33330-4748
Registry dates
- Enumerated
- 2019-03-21
- Last updated
- 2019-03-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.