NPIMap

Organization Active NPI

Customized Healthcare Solutions LLC

  • Chiropractor
  • Leesburg, FL
National Provider Identifier
1750772372
Registry record updated Feb 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH8400 Issued in FL
Legal business name
CUSTOMIZED HEALTHCARE SOLUTIONS LLC
Practice address
1509 South St Ste 1
Leesburg, FL 34748-6664
Phone
(352) 552-2181
NPI assigned
Feb 18, 2015
Last updated
Feb 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2015

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

Authorized official

Name
Dr. Keith Bostaph, D.C.
Title
Owner
Phone
(352) 552-2181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH8400 FL Primary

Addresses

Primary practice location

1509 South St Ste 1
Leesburg, FL 34748-6664

Mailing address

6053 Spinnaker Loop
Lady Lake, FL 32159-5922
Phone (352) 552-2181

National Provider Directory

National Provider Directory

Locations

1509 South St
Ste 1
Leesburg, FL 34748
Phone (352) 552-2181

NPI Registry JSON

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424217600000",
    "number": "1750772372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6053 SPINNAKER LOOP",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595922",
            "telephone_number": "352-552-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 SOUTH ST STE 1",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347486664",
            "telephone_number": "352-552-2181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMIZED HEALTHCARE SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A",
        "authorized_official_last_name": "BOSTAPH",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-552-2181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH8400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; 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.