Mtu Properties, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MTU PROPERTIES, LLC

Doing business as

Florida Wellness Group

Practice address

12111 Panama City Beach Pkwy
Panama City Beach, FL 32407-2609

Phone

(850) 588-1066

NPI assigned

Sep 17, 2019

Organization subpart

No

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

Authorized official

Name

Evan Ellenberg, PA-C

Title

President

Phone

(850) 588-1066

Specialties & licenses 1

Addresses

Other names 1

• FLORIDA WELLNESS GROUP Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732147200000",
    "number": "1407406820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12111 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12111 PANAMA CITY BEACH PKWY",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324072609",
            "telephone_number": "850-588-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MTU PROPERTIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A",
        "authorized_official_last_name": "ELLENBERG",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "850-588-1066",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FLORIDA WELLNESS GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Aaron Montgomery, LPCC
• Dawna Lynn Moore
• Lauren Michelle Moore, LPTA
• Donna M. Mors, PHARM D
• Kimberly D Moskowitz, MS MD LLC
• Jennifer Ann Murphy
• Madolyn Murrah
• Myra Reed MD PA
• Emma Nelson
• Kelly Nelson

• Family Medicine Physician in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.