Organization Active NPI

Top Medspa & Clinic

  • Primary Care Clinic/Center
  • Lake Mary, FL
National Provider Identifier
1659090694
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
TOP MEDSPA & CLINIC
Practice address
2768 W Lake Mary Blvd
Lake Mary, FL 32746-3524
Phone
(321) 230-6043
Fax
(321) 234-0229
NPI assigned
Aug 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Jonathan Peach, APRN
Title
Provider
Phone
(407) 878-3208

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

2768 W Lake Mary Blvd
Lake Mary, FL 32746-3524

Mailing address

2768 W Lake Mary Blvd
Lake Mary, FL 32746-3524
Phone (407) 878-3208

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL app.kareo.com

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1659090694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2768 W LAKE MARY BLVD",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463524",
            "telephone_number": "407-878-3208",
            "fax_number": "321-234-0229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2768 W LAKE MARY BLVD",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327463524",
            "telephone_number": "321-230-6043",
            "fax_number": "321-234-0229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOP MEDSPA & CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "PEACH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "407-878-3208",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "app.kareo.com",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "address_1": "2768 W Lake Mary Blvd",
            "city": "Lake Mary",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327463524",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.