Staywell LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

AP2024 Issued in FL

Legal business name

STAYWELL LLC

Practice address

5300 W 16TH Ave
106
Hialeah, FL 33012-2104

Phone

(561) 303-8903

NPI assigned

Jun 16, 2014

Organization subpart

No

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

Authorized official

Name

Teresa Cruz, LMT

Title

Owner

Phone

(561) 303-8903

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1609280858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9769 ARBOR OAKS LN",
            "address_2": "204",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334282212",
            "telephone_number": "561-303-8903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 W 16TH AVE",
            "address_2": "106",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330122104",
            "telephone_number": "561-303-8903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STAYWELL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "CRUZ",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-303-8903",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "AP2024",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": "MA60818",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APOMD",
            "identifier": "1578637948",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMT",
            "identifier": "1972898989",
            "state": "FL"
        }
    ],
    "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 16, 2014; 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.