Organization Active NPI

Anxiety Treatment of Florida LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Ponte Vedra, FL
National Provider Identifier
1265019376
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ANXIETY TREATMENT OF FLORIDA LLC
Practice address
162 Lone Eagle Way
Ponte Vedra, FL 32081-8386
Phone
(904) 930-7670
NPI assigned
Mar 25, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Authorized official

Name
Michael Bloomquist
Title
Member
Phone
(904) 930-7670

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

162 Lone Eagle Way
Ponte Vedra, FL 32081-8386

Mailing address

PO Box 2527
Ponte Vedra Beach, FL 32004-2527
Phone (904) 930-7670

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1616630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616630400000",
    "number": "1265019376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2527",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320042527",
            "telephone_number": "904-930-7670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 LONE EAGLE WAY",
            "city": "PONTE VEDRA",
            "state": "FL",
            "postal_code": "320818386",
            "telephone_number": "904-930-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANXIETY TREATMENT OF FLORIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-25",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A",
        "authorized_official_last_name": "BLOOMQUIST",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "904-930-7670"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ponte Vedra, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.