NPIMap

Organization Active NPI

Nautilus Health Care Group, LLC

  • General Practice Physician
  • Brooksville, FL
National Provider Identifier
1023788569
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
NAUTILUS HEALTH CARE GROUP, LLC
Practice address
11371 Cortez Blvd Ste 134
Brooksville, FL 34613-5408
Phone
(352) 606-7182
Fax
(352) 606-7482
NPI assigned
Sep 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Denise Tiencken
Title
Ceo
Phone
(904) 446-3519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

11371 Cortez Blvd Ste 134
Brooksville, FL 34613-5408

Mailing address

5220 Belfort Rd Ste 130
Jacksonville, FL 32256-6018
Phone (904) 446-3686

National Provider Directory

National Provider Directory
Tax ID family
Nautilus Health Care Group6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1023788569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD STE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566018",
            "telephone_number": "904-446-3686",
            "fax_number": "904-446-3032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11371 CORTEZ BLVD STE 134",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135408",
            "telephone_number": "352-606-7182",
            "fax_number": "352-606-7482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAUTILUS HEALTH CARE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "TIENCKEN",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-446-3519"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.