Active NPI
Top Medspa & Clinic
- Primary Care Clinic/Center
- Lake Mary, FL
National Provider Identifier
1659090694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | app.kareo.com |
National Provider Directory
National Provider DirectoryNPI 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.