Quality Health & Life Clinic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH11025 Issued in FL

Legal business name

QUALITY HEALTH & LIFE CLINIC LLC

Practice address

2002 Del Prado Blvd S
Suite 104
Cape Coral, FL 33990-4557

Phone

(230) 673-6501

NPI assigned

Oct 14, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Bryon Gabriel Blackwell, D.C.

Title

Owner

Phone

(239) 673-6501

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381708800000",
    "number": "1093143877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 DEL PRADO BLVD S",
            "address_2": "SUITE 104",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339904557",
            "telephone_number": "230-673-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 DEL PRADO BLVD S",
            "address_2": "SUITE 104",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339904557",
            "telephone_number": "230-673-6501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY HEALTH & LIFE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2013-10-14",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "BRYON",
        "authorized_official_middle_name": "GABRIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-673-6501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH11025",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2013; 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.