Medwell, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH9295 Issued in FL

Legal business name

MEDWELL, LLC

Practice address

685 Palm Springs Dr Ste 1C
Altamonte Springs, FL 32701-7853

Phone

(407) 332-7080

NPI assigned

Jun 17, 2013

Organization subpart

No

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

Authorized official

Name

Yaser Mussa-Jimenez, DC

Title

Owner

Phone

(407) 332-7080

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371427200000",
    "number": "1356780985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 PALM SPRINGS DR STE 1C",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327017853",
            "telephone_number": "407-332-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 PALM SPRINGS DR STE 1C",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327017853",
            "telephone_number": "407-332-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDWELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A",
        "authorized_official_last_name": "MUSSA-JIMENEZ",
        "authorized_official_first_name": "YASER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-332-7080",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.