Organization Active NPI

Healthy Bodies Medical Center

  • Clinic/Center
  • Brandon, FL
National Provider Identifier
1265972103
Registry record updated Feb 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
OS11874 Issued in FL
Legal business name
HEALTHY BODIES MEDICAL CENTER
Practice address
3415 Brook Crossing Dr
Brandon, FL 33511-8181
Phone
(813) 540-5005
NPI assigned
Feb 25, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2017

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

Authorized official

Name
Watson Ducatel, D.O.NPI 1811277577
Title
Physician
Phone
(813) 540-5005

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X OS11874 FL Primary

Addresses

Primary practice location

3415 Brook Crossing Dr
Brandon, FL 33511-8181

Mailing address

PO Box 484
Thonotosassa, FL 33592-0484

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2232810Healthy Bodies Medical Center, LLC3415 Brook Crossing Dr, Brandon, FL 33511Certificate of waiverAug 17, 2027

National Provider Directory

National Provider Directory

Locations

3415 Brook Crossing Dr
Brandon, FL 33511
Phone (813) 540-5005

Practitioners & affiliated clinicians

Practitioners 2

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": "1487980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487980800000",
    "number": "1265972103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 484",
            "city": "THONOTOSASSA",
            "state": "FL",
            "postal_code": "335920484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 BROOK CROSSING DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335118181",
            "telephone_number": "813-540-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY BODIES MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-25",
        "last_updated": "2017-02-25",
        "status": "A",
        "authorized_official_last_name": "DUCATEL",
        "authorized_official_first_name": "WATSON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "813-540-5005",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "OS11874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.