NPIMap

Organization Active NPI

Vivid Recovery LLC

  • Acupuncturist
  • Orlando, FL
National Provider Identifier
1033642913
Registry record updated Apr 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP03778 Issued in FL
Legal business name
VIVID RECOVERY LLC
Practice address
3101 Maguire Blvd
Orlando, FL 32803-3763
Phone
(727) 776-9949
NPI assigned
Apr 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2017

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

Authorized official

Name
Dr. Veronika Tynes, DIPL OM, LACNPI 1295287704
Title
Acupuncture Physician
Phone
(727) 776-9949

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
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X AP03778 FL Primary

Addresses

Primary practice location

3101 Maguire Blvd
Orlando, FL 32803-3763

Mailing address

5005 Gardens Dr
Orlando, FL 32812-8782
Phone (727) 776-9949

Other names 1

  • Vivid Recovery Doing business as

National Provider Directory

National Provider Directory

Locations

3101 Maguire Blvd
Orlando, FL 32803
Phone (727) 776-9949

Practitioners & affiliated clinicians

Practitioners 1

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": "1491436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491436800000",
    "number": "1033642913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 GARDENS DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328128782",
            "telephone_number": "727-776-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 MAGUIRE BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328033763",
            "telephone_number": "727-776-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVID RECOVERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-06",
        "last_updated": "2017-04-06",
        "status": "A",
        "authorized_official_last_name": "TYNES",
        "authorized_official_first_name": "VERONIKA",
        "authorized_official_title_or_position": "ACUPUNCTURE PHYSICIAN",
        "authorized_official_telephone_number": "727-776-9949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DIPL OM, LAC"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP03778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vivid Recovery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.