NPIMap

Organization Active NPI

Live Love Life, Inc

  • Community Health Clinic/Center
  • Orlando, FL
National Provider Identifier
1518569573
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
LIVE LOVE LIFE, INC
Practice address
5000 W Colonial Dr
Suite 110
Orlando, FL 32808-7602
Phone
(407) 847-4829
Fax
(386) 272-7938
NPI assigned
Nov 13, 2020
Organization subpart
Yes
Parent organization
LIVE LOVE LIFE, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Mr. Mark A. Walczyk
Title
Chief Operating Officer
Phone
(585) 233-0105

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Voluntary or Charitable Agency 251V00000X
Community Health Clinic/Center 261QC1500X Primary
State or Local Public Health Clinic/Center 261QP0905X

Addresses

Primary practice location

5000 W Colonial Dr
Suite 110
Orlando, FL 32808-7602

Mailing address

5000 W Colonial Dr
Ste 110
Orlando, FL 32808-7602
Phone (407) 847-4829

Other names 1

  • LIVE LOVE LIFE, ORLANDO Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Live Love Life Inc3 organizations share this tax ID, including this one
Part of
Live Love Life Inc

Other organizations with this tax ID 2

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

Locations

5000 W Colonial Dr
Ste 110
Orlando, FL 32808
Phone (407) 847-4829

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1518569573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 W COLONIAL DR",
            "address_2": "STE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087602",
            "telephone_number": "407-847-4829",
            "fax_number": "386-272-7938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 W COLONIAL DR",
            "address_2": "SUITE 110",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328087602",
            "telephone_number": "407-847-4829",
            "fax_number": "386-272-7938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE LOVE LIFE, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVE LOVE LIFE, INC",
        "enumeration_date": "2020-11-13",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "WALCZYK",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "585-233-0105",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIVE LOVE LIFE, ORLANDO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.