Goodlife Healthcare, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

GOODLIFE HEALTHCARE, LLC

Practice address

13 Ryant Blvd
Sebring, FL 33870-8075

Phone

(863) 382-4445

Fax

(863) 382-4447

NPI assigned

Jun 11, 2020

Last updated

Jun 11, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Keatley WaldronNPI 1205948536

Title

Managing Member

Phone

(863) 382-4445

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David K Waldron, D.C.

  • Chiropractor
  • Sebring, FL
  • NPI 1205948536
  Medicare reassignment Care Compare group NPD Authorized official
• McKenna Cobb, APRN

  • Family Nurse Practitioner
  • Sebring, FL
  • NPI 1003419383
  Medicare reassignment Care Compare group NPD
• Gary Montsdeoca, M.D.

  • Specialist
  • Sebring, FL
  • NPI 1508899402
  NPD (past)

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

{
    "created_epoch": "1591833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591833600000",
    "number": "1053936427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 RYANT BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338708075",
            "telephone_number": "863-382-4445",
            "fax_number": "863-382-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 RYANT BLVD",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "338708075",
            "telephone_number": "863-382-4445",
            "fax_number": "863-382-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODLIFE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-11",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A",
        "authorized_official_last_name": "WALDRON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KEATLEY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "863-382-4445"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jorge F Gonzalez Jirau, MD
• Bernabe Gonzalez-Crespo, LMHC, MA
• Christian Gonzalez-Torres, MD
• Celine Gonzalez
• Jacqueline Gonzalez, DMD
• Greater Florida Adult Care
• Greater Florida Anesthesiologists, LLC
• Greater Florida Anesthesiologists, LLC
• Greater Florida Anesthesiologists, LLC
• Amber Anne Green, COTA/L

• Nurse Practitioner in Sebring, FL
• Providers in Sebring, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.