Ely Health Plus LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ELY HEALTH PLUS LLC

Practice address

928 Park Ave
Lake Park, FL 33403-2404

Phone

(619) 173-5025

NPI assigned

Jul 30, 2026

Organization subpart

No

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

Authorized official

Name

James Dedeker

Title

Manager

Phone

(619) 173-5025

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1785369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787875200000",
    "number": "1124941901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840406",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330842406",
            "telephone_number": "619-173-5025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 PARK AVE",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334032404",
            "telephone_number": "619-173-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELY HEALTH PLUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-30",
        "last_updated": "2026-08-28",
        "certification_date": "2026-08-28",
        "status": "A",
        "authorized_official_last_name": "DEDEKER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "619-173-5025"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in Lake Park, FL
• Providers in Lake Park, FL by specialty
• Community/Retail Pharmacy in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2026; 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.