A Rejuvenated Healthcare LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

A REJUVENATED HEALTHCARE LLC

Practice address

3641 Tyrone Blvd N Ste 3
St Petersburg, FL 33710-1150

Phone

(727) 301-9628

NPI assigned

Mar 31, 2019

Last updated

May 1, 2019By 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

Jeremiah Klotz

Title

Office Manager

Phone

(727) 767-0168

Specialties & licenses 1

Addresses

Other names 1

• A REJUVENATED HEALTHCARE LLC Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tanya M Trussel, APRN-FNP-CB

  • Family Nurse Practitioner
  • St Petersburg, FL
  • NPI 1881163590
  NPD

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

{
    "created_epoch": "1553990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1245791235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3641 TYRONE BLVD N STE 3",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101150",
            "telephone_number": "727-301-9628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3641 TYRONE BLVD N STE 3",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101150",
            "telephone_number": "727-301-9628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A REJUVENATED HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-31",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "KLOTZ",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "727-767-0168"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A REJUVENATED HEALTHCARE LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "A REJUVENATED HEALTHCARE LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Primary Care Clinic/Center in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.