Summit Wellness Solutions LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

SUMMIT WELLNESS SOLUTIONS LLC

Practice address

204 Morningview Dr
Eustis, FL 32726-4277

Phone

(813) 857-1794

NPI assigned

Apr 25, 2021

Last updated

Apr 25, 2021By 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

Javier Santiago

Title

Owner/Ceo

Phone

(813) 857-1794

Specialties & licenses 3

Addresses

Electronic endpoints 2

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

{
    "created_epoch": "1619308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619308800000",
    "number": "1225610629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MORNINGVIEW DR",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327264277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MORNINGVIEW DR",
            "city": "EUSTIS",
            "state": "FL",
            "postal_code": "327264277",
            "telephone_number": "813-857-1794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT WELLNESS SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-25",
        "last_updated": "2021-04-25",
        "certification_date": "2021-04-25",
        "status": "A",
        "authorized_official_last_name": "SANTIAGO",
        "authorized_official_first_name": "JAVIER",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "813-857-1794"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Eustis",
            "affiliation": "N",
            "address_1": "204 Morningview Dr",
            "city": "Eustis",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327264277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Eustis",
            "affiliation": "N",
            "address_1": "204 Morningview Dr",
            "city": "Eustis",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327264277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Eustis, FL
• Providers in Eustis, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.

Verify at the official NPI Registry.