Provider Profile

WAVE MEDICAL CENTER INC

Health Care Clinic

FACILITY PROFILE

Facility Closed image
Street Address
Mailing Address
AHCA Reports
Inspection Reports
Inspection Details
Facility Information:
Facility/Provider Type:Health Care Clinic
Medical or Clinic Director:Not Available
Administrator:EFREN QUINTERO
Owner/Licensee:WAVE MEDICAL CENTER INC
Owner/Licensee Since:11/8/2023

NamePositionOwnership
DIANELYS MAURELLESBOARD MEMBER/OFFICER50%
EFREN QUINTEROBOARD MEMBER/OFFICER50%
Profit Status:For-Profit
Licensed Beds:Not Available
AHCA Number (File Number):16053
AHCA Field Office:11
License Number:14138
Current License Effective:5/10/2024
Current License Expires:2/5/2026
License Status:CLOSED

NameLast Used
WAVE MEDICAL CENTER INC11/8/2023
Services/Characteristics
Specialty:PIP Recipient
Type:Fixed Location

Important information and facility/provider definitions can be found in the Glossary.

Attn Providers: Requests for changes in data must be sent in writing to the AHCA licensing office.