Customized Wellness, LLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

CUSTOMIZED WELLNESS, LLC

Practice address

131 W Center Avenue
Sebring, FL 33870

Phone

(863) 658-1764

Fax

(855) 847-8646

NPI assigned

Sep 17, 2019

Last updated

Sep 17, 2019By 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

Amanda C Lucero, APRN

Title

Owner/Provider

Phone

(863) 658-1764

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Carlene Lucero Hanks, APRN

  • Adult Health Nurse Practitioner
  • Sebring, FL
  • NPI 1316913239
  Medicare reassignment NPD

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

{
    "created_epoch": "1568678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568678400000",
    "number": "1790335164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 W CENTER AVENUE",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "33870",
            "telephone_number": "863-658-1764",
            "fax_number": "855-847-8646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 W CENTER AVENUE",
            "city": "SEBRING",
            "state": "FL",
            "postal_code": "33870",
            "telephone_number": "863-658-1764",
            "fax_number": "855-847-8646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMIZED WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-17",
        "last_updated": "2019-09-17",
        "status": "A",
        "authorized_official_last_name": "LUCERO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "863-658-1764",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joel Dennis Cruz
• Casey Lanee Culpepper, LPN
• David Christopher Cummings, MD
• Deborah Ann Cummisky, LPN
• Curb Your Stress Massage LLC (Curb Your Stress Massage)
• Bethony L Cuyler, RA
• Cypress Medical Associates, P.a.
• Cypress Roots Counseling LLC
• D.M. Upadhyaya, M.D., P.a.
• Surbhi Dadwal, MD

• Gynecology Physician in Sebring, FL
• Providers in Sebring, FL by specialty
• Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.