NPIMap

Organization Active NPI

Ethos Health Lakeland, LLC

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
National Provider Identifier
1013409598
Registry record updated Oct 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ETHOS HEALTH LAKELAND, LLC
Practice address
625 Commerce Dr Ste 104
Lakeland, FL 33813-2733
Phone
(352) 732-5590
Fax
(352) 732-0292
NPI assigned
May 31, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jonathan WalkerNPI 1801092218
Title
Owner/Operator
Phone
(352) 732-5590

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

625 Commerce Dr Ste 104
Lakeland, FL 33813-2733

Mailing address

1541 SE 17TH St
Ocala, FL 34471-4607
Phone (352) 732-5590

National Provider Directory

National Provider Directory

Locations

625 Commerce Dr
Ste 104
Lakeland, FL 33813
Phone (863) 232-5288

336 W Highland Dr
Lakeland, FL 33813
Phone (863) 232-5288

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634083200000",
    "number": "1013409598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714607",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 COMMERCE DR STE 104",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132733",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS HEALTH LAKELAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-10-13",
        "certification_date": "2021-10-13",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "352-732-5590"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.