Florida Elite Management LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

FLORIDA ELITE MANAGEMENT LLC

Practice address

20525 Amberfield Dr Unit 104
Land O Lakes, FL 34638-4381

Phone

(813) 536-7281

NPI assigned

Sep 15, 2020

Last updated

Sep 15, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chris Brisch

Title

VP of Finance

Phone

(813) 536-7281

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1600128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1770198723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20525 AMBERFIELD DR UNIT 104",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346384381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20525 AMBERFIELD DR UNIT 104",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346384381",
            "telephone_number": "813-536-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA ELITE MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-15",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "BRISCH",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "813-536-7281"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.