Florida Telehealth LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW10196 Issued in FL

Legal business name

FLORIDA TELEHEALTH LLC

Practice address

4060 Bruing St
North Port, FL 34286-2466

Phone

(941) 220-8256

NPI assigned

Oct 24, 2016

Organization subpart

No

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

Authorized official

Name

Kristin Jones, LCSW

Title

Ceo

Phone

(941) 220-8256

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477267200000",
    "number": "1750832853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 BRUING ST",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342862466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 BRUING ST",
            "city": "NORTH PORT",
            "state": "FL",
            "postal_code": "342862466",
            "telephone_number": "941-220-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA TELEHEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-24",
        "last_updated": "2016-10-24",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "941-220-8256",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW10196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in North Port, FL
• Providers in North Port, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2016; 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.