Organization Active NPI

Elite Recovery & Cryo

  • Critical Care Medicine (Internal Medicine) Physician
  • Clermont, FL
National Provider Identifier
1134965924
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
Legal business name
ELITE RECOVERY & CRYO
Practice address
2410 E Sr 50
Clermont, FL 34711-6020
Phone
(352) 459-8148
NPI assigned
Jul 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Authorized official

Name
Marcus Jorgensen
Title
Owner
Phone
(352) 459-8148

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X Primary

Addresses

Primary practice location

2410 E Sr 50
Clermont, FL 34711-6020

Mailing address

6952 Church Lake St
Groveland, FL 34736-8138

National Provider Directory

National Provider Directory

Locations

2410 E Sr 50
Clermont, FL 34711
Phone (352) 459-8148

Practitioners & affiliated clinicians

Practitioners 1

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": "1719878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1134965924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6952 CHURCH LAKE ST",
            "city": "GROVELAND",
            "state": "FL",
            "postal_code": "347368138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 E SR 50",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347116020",
            "telephone_number": "352-459-8148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE RECOVERY & CRYO",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-02",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "JORGENSEN",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-459-8148"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.