Organization Active NPI

Central Florida Wellness

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1477419190
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CENTRAL FLORIDA WELLNESS
Practice address
3202 W Kennedy Blvd Ste 2
Tampa, FL 33609-3245
Phone
(407) 226-2993
NPI assigned
Dec 26, 2025
Last updated
Dec 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Authorized official

Name
John T Shortly
Title
Owner
Phone
(863) 559-3434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3202 W Kennedy Blvd Ste 2
Tampa, FL 33609-3245

Mailing address

3202 W Kennedy Blvd Ste 2
Tampa, FL 33609-3245
Phone (407) 226-2993

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2002986Central Florida Wellness LLC3202 West Kennedy Blvd Unit 2, Tampa, FL 33609Certificate of waiverJan 28, 2028

National Provider Directory

National Provider Directory
Tax ID family
Central Florida Wellness LLC7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3202 W Kennedy Blvd
Ste 2
Tampa, FL 33609
Phone (305) 438-8770

NPI Registry JSON

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

{
    "created_epoch": "1766707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766707200000",
    "number": "1477419190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3202 W KENNEDY BLVD STE 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093245",
            "telephone_number": "407-226-2993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3202 W KENNEDY BLVD STE 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336093245",
            "telephone_number": "407-226-2993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-26",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A",
        "authorized_official_last_name": "SHORTLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-559-3434"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; 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.