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SOUTHERN WELLCARE MEDICAL PC
NPI 1396090932
Family Medicine in Bronx, NY

Active since July 19, 2012
2336 GRAND CONCOURSE, BRONX, NY 10458(718) 907-0195 Get Directions Write a Review

NPPES record last updated: October 17, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Southern Wellcare Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN WELLCARE MEDICAL PC (NPI 1396090932) is a healthcare organization registered as a family medicine in Bronx, New York and active in the NPI registry since July 2012. The organization lists Svetlana Khandros, President, as its authorized official.

NPPES Registry Identity

NPI1396090932
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTHERN WELLCARE MEDICAL PC
Location Address2336 GRAND CONCOURSEBronx, NY 10458-6903
Mailing Address2336 Grand ConcourseBronx, NY 10458-6903 · (718) 220-0439 · Fax (718) 933-2914
Phone(718) 907-0195
Organization SubpartNo
Authorized OfficialSvetlana KhandrosPresident · (718) 220-0439
Enumeration DateJuly 19, 2012
Last NPPES UpdateOctober 17, 2019
✔ NPI 1396090932 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in NY · 228243
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
2336 GRAND CONCOURSE, Bronx, NY 10458
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PINNACLE DENTAL CARE P.C.
Dentist
2336 GRAND CONCOURSE
BRONX, NY 10458
Bronx County (718) 220-0439
MARIA A. MUNIZ D.D.S
Dentist (General Practice)
2336 GRAND CONCOURSE
BRONX, NY 10458
Bronx County (718) 220-0439
URBAN MEDICAL SERVICES OF BX PC
Family Medicine
2336 GRAND CONCOURSE
BRONX, NY 10458
Bronx County (718) 220-0439
MR. TANGING D SHERPA PA
Physician Assistant
2336 GRAND CONCOURSE
BRONX, NY 10458
Bronx County (718) 220-0439
SHIRLEY CARLOS-CU NP-C
Nurse Practitioner (Adult Health)
2336 GRAND CONCOURSE
BRONX, NY 10458
Bronx County (718) 220-0439
AKOSUA POKUAA ADJABENG
Nurse Practitioner (Family)
2336 GRAND CONCOURSE
BRONX, NY 10458
Bronx County (718) 844-1424
MS. PHELAN ANTONIA CLANCY A.N.P
Nurse Practitioner (Adult Health)
2336 GRAND CONCOURSE
BRONX, NY 10458
Bronx County (718) 220-0439
PLANET PHARMACY LLC
Pharmacy
2336 GRAND CONCOURSE
BRONX, NY 10458
Bronx County (718) 220-2035

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Wellcare Medical PC's NPI number?

The NPI number for Southern Wellcare Medical PC is 1396090932. It was assigned to this organization in the NPPES registry on July 19, 2012.

Where is Southern Wellcare Medical PC located?

Southern Wellcare Medical PC is located at 2336 Grand Concourse, Bronx, NY 10458. The listed phone number is (718) 907-0195.

What is Southern Wellcare Medical PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Southern Wellcare Medical PC was last updated on October 17, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.