Excellent Life Design Corporation

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MT2629 Issued in FL

Legal business name

EXCELLENT LIFE DESIGN CORPORATION

Practice address

1540 International Pkwy
Suite 2000
Lake Mary, FL 32746-5096

Phone

(407) 536-5120

Fax

(810) 222-0685

NPI assigned

Mar 26, 2013

Organization subpart

No

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

Authorized official

Name

Rhonda Baker

Title

Ceo

Phone

(407) 536-5120

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1285976340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1540 INTERNATIONAL PKWY",
            "address_2": "SUITE 2000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465096",
            "telephone_number": "407-536-5120",
            "fax_number": "810-222-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 INTERNATIONAL PKWY",
            "address_2": "SUITE 2000",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327465096",
            "telephone_number": "407-536-5120",
            "fax_number": "810-222-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLENT LIFE DESIGN CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-26",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-536-5120"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "MT2629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Community/Behavioral Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.