Organization Active NPI

Wellquest Lifestyle Rehabilitation, LLC

  • Acupuncturist
  • Brandon, FL
National Provider Identifier
1699366385
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
Legal business name
WELLQUEST LIFESTYLE REHABILITATION, LLC
Practice address
345 E Robertson St
Brandon, FL 33511-5253
Phone
(813) 404-6006
NPI assigned
Jan 27, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Authorized official

Name
Camille Clark
Title
Medical Billing Associate
Phone
(754) 205-6154

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X Primary

Addresses

Primary practice location

345 E Robertson St
Brandon, FL 33511-5253

Mailing address

110 Mitchell Dr
Brandon, FL 33511-6831
Phone (813) 404-6006

National Provider Directory

National Provider Directory

Locations

345 E Robertson St
Brandon, FL 33511
Phone (813) 404-6006

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": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1699366385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MITCHELL DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116831",
            "telephone_number": "813-404-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 E ROBERTSON ST",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115253",
            "telephone_number": "813-404-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLQUEST LIFESTYLE REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CAMILLE",
        "authorized_official_title_or_position": "MEDICAL BILLING ASSOCIATE",
        "authorized_official_telephone_number": "754-205-6154"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.