Organization Active NPI

My Doctors Live Network

  • Multi-Specialty Clinic/Center
  • Lakeland, FL
National Provider Identifier
1144891367
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
MY DOCTORS LIVE NETWORK
Practice address
170 Fitzgerald Rd Ste 1
Lakeland, FL 33813-2633
Phone
(800) 838-8840
NPI assigned
Jul 8, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Rachel V Ollivierre-Agard, MD
Title
Owner
Phone
(800) 838-8840

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Genetic Counselor (M.S.)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 170300000X
General Practice PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208D00000X
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

170 Fitzgerald Rd Ste 1
Lakeland, FL 33813-2633

Mailing address

170 Fitzgerald Rd Ste 1
Lakeland, FL 33813-2633
Phone (800) 838-8840

National Provider Directory

National Provider Directory

Locations

210 N Missouri Ave
Unit 809
Lakeland, FL 33802

NPI Registry JSON

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1144891367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 FITZGERALD RD STE 1",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132633",
            "telephone_number": "800-838-8840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 FITZGERALD RD STE 1",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132633",
            "telephone_number": "800-838-8840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY DOCTORS LIVE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-08",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "OLLIVIERRE-AGARD",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "800-838-8840",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "170300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Genetic Counselor, MS",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; 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.