Organization Active NPI

Summit Wellness of Jupiter, LLC

  • Family Medicine Physician
  • Jupiter, FL
National Provider Identifier
1154911543
Registry record updated Jul 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SUMMIT WELLNESS OF JUPITER, LLC
Practice address
250 S Central Blvd Ste 106
Jupiter, FL 33458-8812
Phone
(561) 309-4767
NPI assigned
Jan 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2023

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

Authorized official

Name
Victoria L Canarelli, APRNNPI 1669825238
Title
Ceo
Phone
(561) 309-4767

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

250 S Central Blvd Ste 106
Jupiter, FL 33458-8812

Mailing address

6650 W Indiantown Rd Ste 200-57
Jupiter, FL 33458-4628
Phone (561) 309-4767

National Provider Directory

National Provider Directory

Locations

6650 W Indiantown Rd
Ste 20057
Jupiter, FL 33458

250 S Central Blvd
Ste 106
Jupiter, FL 33458
Phone (561) 309-4767

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": "1611100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688947200000",
    "number": "1154911543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6650 W INDIANTOWN RD STE 200-57",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334584628",
            "telephone_number": "561-309-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S CENTRAL BLVD STE 106",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334588812",
            "telephone_number": "561-309-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT WELLNESS OF JUPITER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-20",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A",
        "authorized_official_last_name": "CANARELLI",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-309-4767",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.