The Refinery Medspa and Wellnes, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

THE REFINERY MEDSPA AND WELLNES, LLC

Practice address

4311 Norfolk Pkwy Ste 114
West Melbourne, FL 32904-8617

Phone

(321) 722-6200

NPI assigned

Mar 22, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Jarrod James Stoldt

Title

President

Phone

(321) 917-2217

Specialties & licenses 1

Addresses

Other names 1

• Panacea Medical Associates, LLC Former legal business name

Locations

Practitioners 1

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

• Lauren Long, NP

  • Nurse Practitioner
  • Melbourne, FL
  • NPI 1750861985
  NPD (past)

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521676800000",
    "number": "1255835211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 E RIVER OAKS DR",
            "city": "INDIALANTIC",
            "state": "FL",
            "postal_code": "329034630",
            "telephone_number": "321-917-2217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4311 NORFOLK PKWY STE 114",
            "city": "WEST MELBOURNE",
            "state": "FL",
            "postal_code": "329048617",
            "telephone_number": "321-722-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE REFINERY MEDSPA AND WELLNES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2018-03-22",
        "status": "A",
        "authorized_official_last_name": "STOLDT",
        "authorized_official_first_name": "JARROD",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-917-2217",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Panacea Medical Associates, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• America Tarpein, MSW
• Reinier Tejeda Gonzalez, DDS
• Alexandria Bailey Terrill
• Christopher Thaver, MD
• The Healing Path, Family Counseling Center, Inc.
• Danielle Thibeault
• Nikeya M Thomas, RDN, LDN
• Jennifer Tinelli, ARNP
• Robert Scott Tomerlin, PHARM.D
• Damaris Torres, MA, LMHC

• Health Service Clinic/Center in West Melbourne, FL
• Providers in West Melbourne, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2018; 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.