Active NPI
Elevate Your Existence, LLC
- Optometrist
- Tampa, FL
National Provider Identifier
1164935474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4928
- Legal business name
- ELEVATE YOUR EXISTENCE, LLC
- Practice address
- 8150 Citrus Park Town Center Mall SPC 1100
Tampa, FL 33625-3181 - Phone
- (813) 920-6824
- Fax
- (813) 920-6619
- NPI assigned
- Nov 8, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Bradley Austin, OD
- Title
- Owner
- Phone
- (954) 696-3288
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4928 | FL | Primary |
Addresses
Primary practice location
8150 Citrus Park Town Center Mall SPC 1100
Tampa, FL 33625-3181
Mailing address
3056 Satilla Loop
Odessa, FL 33556-2739
Phone (954) 696-3288
Other practice location 1
28150 Willet Way
Wesley Chapel, FL 33543-5482
Phone (813) 907-3126
Other practice location 2
9644 Scenic Dr
Port Richey, FL 34668-4653
Phone (727) 845-0082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014824000 | Medicaid | FL |
National Provider Directory
National Provider DirectoryLocations
8150 Citrus Park Town Ctr
Ste 1100
Tampa, FL 33625
Phone (813) 920-6718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510099200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1622332800000",
"number": "1164935474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3056 SATILLA LOOP",
"city": "ODESSA",
"state": "FL",
"postal_code": "335562739",
"telephone_number": "954-696-3288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8150 CITRUS PARK TOWN CENTER MALL SPC 1100",
"city": "TAMPA",
"state": "FL",
"postal_code": "336253181",
"telephone_number": "813-920-6824",
"fax_number": "813-920-6619"
}
],
"practiceLocations": [
{
"address_1": "28150 Willet Way",
"address_purpose": "LOCATION",
"city": "Wesley Chapel",
"state": "FL",
"postal_code": "335435482",
"country_code": "US",
"telephone_number": "813-907-3126",
"fax_number": "813-482-0027",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9644 Scenic Dr",
"address_purpose": "LOCATION",
"city": "Port Richey",
"state": "FL",
"postal_code": "346684653",
"country_code": "US",
"telephone_number": "727-845-0082",
"fax_number": "727-877-2251",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "ELEVATE YOUR EXISTENCE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-11-08",
"last_updated": "2021-05-30",
"certification_date": "2021-05-30",
"status": "A",
"authorized_official_last_name": "AUSTIN",
"authorized_official_first_name": "BRADLEY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "954-696-3288",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Optometrist",
"state": "FL",
"license": "4928",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014824000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.