NPIMap

Organization Active NPI

LQV West Palm Beach

  • Clinic/Center
  • West Palm, FL
National Provider Identifier
1083297071
Registry record updated Apr 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LQV WEST PALM BEACH
Doing business as
Liquivida Lounge
Practice address
1460 Hippocrates Way
2ND Floor
West Palm, FL 33411
Phone
(561) 463-8227
NPI assigned
Apr 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2021

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

Authorized official

Name
Blake Engle
Title
Corporate District Manager
Phone
(954) 650-2130

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

1460 Hippocrates Way
2ND Floor
West Palm, FL 33411

Mailing address

1460 Hippocrates Way
2ND Floor
West Palm, FL 33411

Other names 1

  • Liquivida Lounge Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619568000000",
    "number": "1083297071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 HIPPOCRATES WAY",
            "address_2": "2ND FLOOR",
            "city": "WEST PALM",
            "state": "FL",
            "postal_code": "33411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 HIPPOCRATES WAY",
            "address_2": "2ND FLOOR",
            "city": "WEST PALM",
            "state": "FL",
            "postal_code": "33411",
            "telephone_number": "561-463-8227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LQV WEST PALM BEACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2021-04-28",
        "certification_date": "2021-04-01",
        "status": "A",
        "authorized_official_last_name": "ENGLE",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "CORPORATE DISTRICT MANAGER",
        "authorized_official_telephone_number": "954-650-2130"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Liquivida Lounge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Palm, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.