Axel1 Health LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME91067 Issued in FL

Legal business name

AXEL1 HEALTH LLC

Practice address

4820 Griffin Blvd
Fort Myers, FL 33908-2016

Phone

(239) 872-9734

Fax

(877) 334-9599

NPI assigned

Oct 28, 2015

Organization subpart

No

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

Authorized official

Name

Sumeet Shetty, MD

Title

Owner

Phone

(239) 872-9734

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1445990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1215309331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 GRIFFIN BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339082016",
            "telephone_number": "239-872-9734",
            "fax_number": "877-334-9599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 GRIFFIN BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339082016",
            "telephone_number": "239-872-9734",
            "fax_number": "877-334-9599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXEL1 HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-28",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "SHETTY",
        "authorized_official_first_name": "SUMEET",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-872-9734",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME91067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amanda Axel
• Daniel Louis Axelrod, M.D.
• Axis Natural Medicine, LLC
• Beverly Ayala-Kincaid, APRN
• Lauren Emily Ayala, M.S., CF-SLP
• Sonia Ayala

• Internal Medicine Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2015; 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.