Rejuvenex Wellness & Medspa

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REJUVENEX WELLNESS & MEDSPA

Practice address

12950 US 301 S
Riverview, FL 33578-7459

Phone

(305) 216-3760

Fax

(740) 756-6021

NPI assigned

Mar 23, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Katherine Elaine Cancel, ARNP

Title

Arnp

Phone

(305) 216-3760

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1619553138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10113 ROSE PETAL PL",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335784948",
            "telephone_number": "305-216-3760",
            "fax_number": "740-756-6021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12950 US 301 S",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335787459",
            "telephone_number": "305-216-3760",
            "fax_number": "740-756-6021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENEX WELLNESS & MEDSPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "CANCEL",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "ARNP",
        "authorized_official_telephone_number": "305-216-3760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Riverview, FL
• Providers in Riverview, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.