Enhanced Lifestyle Senior Healthcare LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ENHANCED LIFESTYLE SENIOR HEALTHCARE LLC

Practice address

2125 Harden Blvd
Lakeland, FL 33803-5918

Phone

(863) 838-8114

Fax

(863) 345-8793

NPI assigned

Jan 26, 2022

Organization subpart

No

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

Authorized official

Name

David Gonzalez

Title

Credentialing

Phone

(813) 453-6179

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Mario Jorge Gonzalez Fernandez, M.D.

  • Internal Medicine Physician
  • Tampa, FL
  • NPI 1427479310
  NPD (past)

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

{
    "created_epoch": "1643155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651795200000",
    "number": "1336891704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338035918",
            "telephone_number": "863-838-8114",
            "fax_number": "863-345-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338035918",
            "telephone_number": "863-838-8114",
            "fax_number": "863-345-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED LIFESTYLE SENIOR HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-26",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "813-453-6179"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enduring Peace Counseling LLC
• Israel Enechukwu, PHARMD
• Ashley Nicole England, PT
• Michael Englert, LMHC, LPC, LCAS
• Alicia Engwall
• Enhanced Lifestyle Senior Healthcare LLC
• Luz C Enriquez Sardinas
• Andrea Lisa Entin, RNFA
• Environmental Concepts and Services
• Joni Melissa Epperson Steven, ARNP

• Physical Therapist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.