NPIMap

Organization Active NPI

Legacy Whole Health, PLLC

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1225949365
Registry record updated Sep 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEGACY WHOLE HEALTH, PLLC
Practice address
3212 Cove Bend Dr
Tampa, FL 33613-2752
Phone
(813) 945-9821
Fax
(813) 742-5412
NPI assigned
Sep 16, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2026

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

Authorized official

Name
Dr. Stania Ayanna Dejesus, DO
Title
Owner
Phone
(646) 662-7578

Specialties & licenses 1

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

Addresses

Primary practice location

3212 Cove Bend Dr
Tampa, FL 33613-2752

Mailing address

3212 Cove Bend Dr
Tampa, FL 33613-2752
Phone (813) 945-9821

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1789516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789516800000",
    "number": "1225949365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3212 COVE BEND DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132752",
            "telephone_number": "813-945-9821",
            "fax_number": "813-742-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3212 COVE BEND DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132752",
            "telephone_number": "813-945-9821",
            "fax_number": "813-742-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY WHOLE HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-16",
        "last_updated": "2026-09-16",
        "certification_date": "2026-09-16",
        "status": "A",
        "authorized_official_last_name": "DEJESUS",
        "authorized_official_first_name": "STANIA",
        "authorized_official_middle_name": "AYANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-662-7578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "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 Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; 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.