Core Concierge Health and Wellness LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CORE CONCIERGE HEALTH AND WELLNESS LLC

Practice address

2550 S Bayshore Dr Ste 204
Miami, FL 33133-4743

Phone

(305) 210-2673

NPI assigned

Jul 6, 2023

Organization subpart

No

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

Authorized official

Name

Ketevan Leo, MDNPI 1750521571

Title

Owner

Phone

(917) 753-4770

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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

• Ketevan Leo, M.D.

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1750521571
  Medicare reassignment Care Compare group NPD Authorized official
• Kristen Ann Doddo, MD

  • Internal Medicine Physician
  • Miami, FL
  • NPI 1558516641
  Medicare reassignment Care Compare group NPD
• Kelly Anne Ulmo, ARNP

  • Nurse Practitioner
  • Miami, FL
  • NPI 1902284367
  NPD (past)

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

{
    "created_epoch": "1688601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710374400000",
    "number": "1285312694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 S BAYSHORE DR STE 204",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334743",
            "telephone_number": "917-753-4770",
            "fax_number": "786-485-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 S BAYSHORE DR STE 204",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334743",
            "telephone_number": "305-210-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE CONCIERGE HEALTH AND WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-06",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A",
        "authorized_official_last_name": "LEO",
        "authorized_official_first_name": "KETEVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-753-4770",
        "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": []
}

• Yareilys Cordovi Rego
• Ana Maria Cordovi
• Elisabeth Cordovi
• Yanet Cordovi, APRN
• Core Comfort Medical Supplies
• Core Transitional Living Communities LLC
• Core Value Insurance Associates LLC
• Core Value Insurance Associates LLC
• Claudia Maria Corea, BA
• Francesca Corea, LMHC

• Internal Medicine Physician in Miami, FL
• Providers in Miami, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.