Active Lifestyles Wellness & Performance Ctr

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT22446 Issued in FL

Legal business name

ACTIVE LIFESTYLES WELLNESS & PERFORMANCE CTR

Practice address

1715 37TH PL
Third Floor
Vero Beach, FL 32960-4502

Phone

(772) 978-7379

Fax

(772) 539-8515

NPI assigned

May 28, 2006

Last updated

Feb 13, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Giorgio G Res, D.C., P.T.NPI 1568418705

Title

Owner

Phone

(772) 978-7379

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Giorgio G Res, D.C., P.T.

  • Physical Therapist
  • Vero Beach, FL
  • NPI 1568418705
  Authorized official Same address or phone

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518480000000",
    "number": "1154378875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 37TH PL",
            "address_2": "THIRD FLOOR",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604502",
            "telephone_number": "772-978-7379",
            "fax_number": "772-539-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 37TH PL",
            "address_2": "THIRD FLOOR",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329604502",
            "telephone_number": "772-978-7379",
            "fax_number": "772-539-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE LIFESTYLES WELLNESS & PERFORMANCE CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2018-02-13",
        "status": "A",
        "authorized_official_last_name": "RES",
        "authorized_official_first_name": "GIORGIO",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-978-7379",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., P.T."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9113",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT22446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; 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.