NPIMap

Organization Active NPI

Florida Wellness Center of Tallahassee, Inc

  • Chiropractor
  • Tallahassee, FL
National Provider Identifier
1104150366
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FLORIDA WELLNESS CENTER OF TALLAHASSEE, INC
Practice address
2339 N Monroe St
Tallahassee, FL 32303-4733
Phone
(850) 385-6664
Fax
(850) 385-2403
NPI assigned
Sep 21, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Dr. Reynaldo Perez, D.C.NPI 1861630071
Title
President
Phone
(850) 385-6664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X
Public Health & General Preventive Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0901X

Addresses

Primary practice location

2339 N Monroe St
Tallahassee, FL 32303-4733

Mailing address

2339 N Monroe St
Tallahassee, FL 32303-4733
Phone (850) 385-6664

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180613000818 FL Part B Supplier - Clinic/Group Practice 2365797438 Receives reassigned benefits from 1 practitioner
Practice locations: Tallahassee, FL

National Provider Directory

National Provider Directory

Locations

2339 N Monroe St
Tallahassee, FL 32303
Phone (850) 385-6664

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1253491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1104150366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2339 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323034733",
            "telephone_number": "850-385-6664",
            "fax_number": "850-385-2403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2339 N MONROE ST",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323034733",
            "telephone_number": "850-385-6664",
            "fax_number": "850-385-2403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA WELLNESS CENTER OF TALLAHASSEE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-21",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "REYNALDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-385-6664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.