NPIMap

Organization Active NPI

Personal Wellness Medicine, LLC

  • Prevention Professional
  • Sarasota, FL
National Provider Identifier
1093306292
Registry record updated Jan 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
Legal business name
PERSONAL WELLNESS MEDICINE, LLC
Practice address
3231 Gulf Gate Dr Ste 102
Sarasota, FL 34231-2406
Phone
(941) 685-8914
Fax
(941) 349-9301
NPI assigned
Jan 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2021

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

Authorized official

Name
David Leggett
Title
Practice Manager
Phone
(941) 685-8914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention ProfessionalGroup: 193400000X SINGLE SPECIALTY GROUP 405300000X Primary

Addresses

Primary practice location

3231 Gulf Gate Dr Ste 102
Sarasota, FL 34231-2406

Mailing address

651 SE 41St Ave
Trenton, FL 32693-5003
Phone (941) 685-8914

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1611964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611964800000",
    "number": "1093306292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 SE 41ST AVE",
            "city": "TRENTON",
            "state": "FL",
            "postal_code": "326935003",
            "telephone_number": "941-685-8914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 GULF GATE DR STE 102",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342312406",
            "telephone_number": "941-685-8914",
            "fax_number": "941-349-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL WELLNESS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-30",
        "last_updated": "2021-01-30",
        "certification_date": "2021-01-30",
        "status": "A",
        "authorized_official_last_name": "LEGGETT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "941-685-8914"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.