Imac Management of Florida, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

IMAC MANAGEMENT OF FLORIDA, LLC

Practice address

24830 S Tamiami TRL Ste 1000
Bonita Springs, FL 34134-7031

Phone

(239) 948-3280

Fax

(239) 236-1719

NPI assigned

Jan 15, 2020

Organization subpart

No

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

Authorized official

Name

Jeff Ervin, CEO

Title

Chief Executive Officer

Phone

(615) 889-0024

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1417597667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 WESTGATE CIR STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370278396",
            "telephone_number": "615-889-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24830 S TAMIAMI TRL STE 1000",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347031",
            "telephone_number": "239-948-3280",
            "fax_number": "239-236-1719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAC MANAGEMENT OF FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "ERVIN",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "615-889-0024",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CHIROPRACTIC LICENSE",
            "identifier": "CH7358",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hsre-Ahr Bonita Springs TRS LLC
• Wendy G Huelsman, MSPT
• Bryan T Hunte, D.C.
• Alyssa Hussey
• Michael Christopher Ianniello, D.O.
• Imed Diagnostic Services of Bonita Springs LLC
• Inmotion Health and Fitness, Inc.
• Inmotion Physical Therapy, LLC
• Innovative Pharmacy Solutions LLC
• Institutional Eye Care LLC

• Multi-Specialty Clinic/Center in Bonita Springs, FL
• Providers in Bonita Springs, 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 Jan 15, 2020; 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.