Elevate Primary Care & Wellness LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

ELEVATE PRIMARY CARE & WELLNESS LLC

Practice address

107 Lake Emma Cove Dr
Lake Mary, FL 32746-2508

Phone

(407) 310-3102

NPI assigned

Jul 11, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Nela F Ballesteros Moyano, MD

Title

Medical Director

Phone

(407) 310-3102

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1720656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1336986827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 LAKE EMMA COVE DR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462508",
            "telephone_number": "407-310-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 LAKE EMMA COVE DR",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462508",
            "telephone_number": "407-310-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE PRIMARY CARE & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-11",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "BALLESTEROS MOYANO",
        "authorized_official_first_name": "NELA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "407-310-3102",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Lake Mary, FL
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• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2024; 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.