Fun Fit Vibe LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

017525 Issued in DE

Legal business name

FUN FIT VIBE LLC

Practice address

1604 Savannah Rd
Lewes, DE 19958-1662

Phone

(302) 249-8000

NPI assigned

Oct 12, 2011

Last updated

Oct 12, 2011By 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

Mr. Gregory Mervine

Title

Coach

Phone

(302) 249-8000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1318377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1093090854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 142",
            "city": "NASSAU",
            "state": "DE",
            "postal_code": "199690142",
            "telephone_number": "302-249-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1604 SAVANNAH RD",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199581662",
            "telephone_number": "302-249-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUN FIT VIBE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-12",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "MERVINE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "COACH",
        "authorized_official_telephone_number": "302-249-8000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "DE",
            "license": "017525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Tara Gambale, SCHOOL PSYCHOLOGIST

• Specialist in Lewes, DE
• Providers in Lewes, DE by specialty
• Specialist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; 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.