Aalwm Clinic PLLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

AALWM CLINIC PLLC

Practice address

1180 Spring Centre South Blvd Ste 355
Altamonte Springs, FL 32714-1999

Phone

(407) 312-4613

Fax

(800) 414-3101

NPI assigned

Apr 29, 2025

Organization subpart

No

Name

Phyleischa Mayne-Owen

Title

Office Manager

Phone

(407) 312-4613

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

• David Harbour, DO

  • Emergency Medicine Physician
  • Rockledge, FL
  • NPI 1851394217

  Emergency Medicine, FL

  Medicare reassignment NPD
• Krista Richardson Randolph

  • Physical Therapist
  • Orlando, FL
  • NPI 1215483565

  FL, Physical Therapist

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 25, 2025.

{
    "created_epoch": "1745884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758758400000",
    "number": "1124816004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 SPRING CENTRE SOUTH BLVD STE 355",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327141999",
            "telephone_number": "407-312-4613",
            "fax_number": "800-414-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 SPRING CENTRE SOUTH BLVD STE 355",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327141999",
            "telephone_number": "407-312-4613",
            "fax_number": "800-414-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AALWM CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-29",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A",
        "authorized_official_last_name": "MAYNE-OWEN",
        "authorized_official_first_name": "PHYLEISCHA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "407-312-4613"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Altamonte Springs, FL
• Rehabilitation Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.