Organization Active NPI

Ageless Body Clinic, LLC

  • Family Medicine Physician
  • Hallandale Beach, FL
National Provider Identifier
1245798461
Registry record updated Dec 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AGELESS BODY CLINIC, LLC
Practice address
2500 E Hallandale Beach Blvd Ste 406
Hallandale Beach, FL 33009-4837
Phone
(954) 990-0302
Fax
(954) 908-7101
NPI assigned
Mar 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2025

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

Authorized official

Name
Inna S Trakhtenberg, DCNPI 1851430102
Title
Ceo - Chiropractor
Phone
(954) 990-0302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

2500 E Hallandale Beach Blvd Ste 406
Hallandale Beach, FL 33009-4837

Mailing address

2500 E Hallandale Beach Blvd Ste 406
Hallandale Beach, FL 33009-4837
Phone (954) 990-0302

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766102400000",
    "number": "1245798461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 E HALLANDALE BEACH BLVD STE 406",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094837",
            "telephone_number": "954-990-0302",
            "fax_number": "954-908-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 E HALLANDALE BEACH BLVD STE 406",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094837",
            "telephone_number": "954-990-0302",
            "fax_number": "954-908-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS BODY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2025-12-19",
        "certification_date": "2025-12-19",
        "status": "A",
        "authorized_official_last_name": "TRAKHTENBERG",
        "authorized_official_first_name": "INNA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO - CHIROPRACTOR",
        "authorized_official_telephone_number": "954-990-0302",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2025; 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.