Organization Active NPI

Amplified Vitality Wellness Clinic, LLC

  • Internal Medicine Physician
  • Fort Lauderdale, FL
National Provider Identifier
1255045209
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
AMPLIFIED VITALITY WELLNESS CLINIC, LLC
Doing business as
Amp Clinic
Practice address
2800 E Commercial Blvd Ste 210
Fort Lauderdale, FL 33308-4228
Phone
(954) 667-3385
Fax
(954) 676-1010
NPI assigned
Jan 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Dr. Christopher Paul Lacross, MD
Title
Medical Director
Phone
(603) 303-3660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2800 E Commercial Blvd Ste 210
Fort Lauderdale, FL 33308-4228

Mailing address

2800 E Commercial Blvd Ste 210
Fort Lauderdale, FL 33308-4228
Phone (954) 667-3385

Other names 1

  • Amp Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1673481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1255045209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 E COMMERCIAL BLVD STE 210",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084228",
            "telephone_number": "954-667-3385",
            "fax_number": "954-676-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 E COMMERCIAL BLVD STE 210",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333084228",
            "telephone_number": "954-667-3385",
            "fax_number": "954-676-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMPLIFIED VITALITY WELLNESS CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-12",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "LACROSS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "603-303-3660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amp Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.