Ethos Health Tampa 4 LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ETHOS HEALTH TAMPA 4 LLC

Practice address

710 Oakfield Dr Ste 105
Brandon, FL 33511-4931

Phone

(352) 732-5590

Fax

(352) 732-0292

NPI assigned

May 31, 2018

Organization subpart

No

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

Authorized official

Name

Jonathan WalkerNPI 1801092218

Title

Owner/Operator

Phone

(352) 732-5590

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Jonathan Ray Walker, D.C.

  • Chiropractor
  • Ocala, FL
  • NPI 1801092218
  NPD (past) Authorized official
• Winona Louise Werts

  • Family Medicine Physician
  • Cocoa, FL
  • NPI 1821501982
  NPD

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628467200000",
    "number": "1326530817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 SE 17TH ST",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344714607",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 OAKFIELD DR STE 105",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114931",
            "telephone_number": "352-732-5590",
            "fax_number": "352-732-0292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETHOS HEALTH TAMPA 4 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "352-732-5590"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Essence of Love Therapy LLC
• Elle Essman, APRN
• James Estes, RDH
• Yanara Maria Estrada Santiago
• Jessica Estrada, PT
• Gislaine Etienne
• Nicolas Etienne
• Ronney Etienne, PT
• Shanelle Etienne, D.C
• David Etter, MD

• Multi-Specialty Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.