Organization Active NPI

St. Johns Wellness Center, LLC

  • Specialist
  • St Augustine, FL
National Provider Identifier
1710152897
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MM18687 Issued in FL
Legal business name
ST. JOHNS WELLNESS CENTER, LLC
Practice address
305 Kingsley Lake Dr
Suite 702
St Augustine, FL 32092-3043
Phone
(904) 537-0674
NPI assigned
Apr 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Ms. Darlene L. Torroll, LMTNPI 1134311426
Title
Owner
Phone
(904) 537-0674

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MM18687 FL Primary

Addresses

Primary practice location

305 Kingsley Lake Dr
Suite 702
St Augustine, FL 32092-3043

Mailing address

4361 Comanche Trail Blvd
Saint Johns, FL 32259-4285
Phone (904) 537-0674

National Provider Directory

National Provider Directory

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": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1710152897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4361 COMANCHE TRAIL BLVD",
            "city": "SAINT JOHNS",
            "state": "FL",
            "postal_code": "322594285",
            "telephone_number": "904-537-0674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 KINGSLEY LAKE DR",
            "address_2": "SUITE 702",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320923043",
            "telephone_number": "904-537-0674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHNS WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "TORROLL",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "904-537-0674",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "MM18687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.