Organization Active NPI

Vitality Family Chiropractic and Wellness Center

  • Chiropractor
  • Jacksonville, FL
National Provider Identifier
1184108557
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VITALITY FAMILY CHIROPRACTIC AND WELLNESS CENTER
Practice address
3636 University Blvd S Ste B3
Jacksonville, FL 32216-4223
Phone
(904) 434-3465
Fax
(904) 802-7977
NPI assigned
Sep 20, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Authorized official

Name
Yamilette Marie Lopez Rivera
Title
Ceo
Phone
(904) 434-3465

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3636 University Blvd S Ste B3
Jacksonville, FL 32216-4223

Mailing address

3636 University Blvd S Ste B3
Jacksonville, FL 32216-4223
Phone (904) 434-3465

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2239885Vitality Family Chiropractic & Wellness Ctr3636 University Blvd S Ste B3, Jacksonville, FL 32216Certificate of waiverOct 13, 2027

National Provider Directory

National Provider Directory

Locations

6349 Beach Blvd
Jacksonville, FL 32216
Phone (904) 434-3465

3636 University Blvd S
Ste B3
Jacksonville, FL 32216
Phone (904) 434-3465

NPI Registry JSON

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

{
    "created_epoch": "1537401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1184108557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 UNIVERSITY BLVD S STE B3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164223",
            "telephone_number": "904-434-3465",
            "fax_number": "904-802-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 UNIVERSITY BLVD S STE B3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164223",
            "telephone_number": "904-434-3465",
            "fax_number": "904-802-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY FAMILY CHIROPRACTIC AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-20",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "LOPEZ RIVERA",
        "authorized_official_first_name": "YAMILETTE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-434-3465"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.