Organization Active NPI

Living Well Health Center of Central Florida Inc

  • General Practice Physician
  • Saint Cloud, FL
National Provider Identifier
1861010266
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
LIVING WELL HEALTH CENTER OF CENTRAL FLORIDA INC
Practice address
4039 13TH St
Saint Cloud, FL 34769-6772
Phone
(407) 957-1337
NPI assigned
Jul 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Authorized official

Name
Richard TakanenNPI 1215236195
Title
Owner
Phone
(407) 957-1337

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
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

4039 13TH St
Saint Cloud, FL 34769-6772

Mailing address

4039 13TH St
Saint Cloud, FL 34769-6772
Phone (407) 957-1337

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201028002613 FL Part B Supplier - Clinic/Group Practice 6901216183 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Cloud, FL

National Provider Directory

National Provider Directory

Locations

4041 13th St
Saint Cloud, FL 34769
Phone (407) 957-1337

Practitioners & affiliated clinicians

Practitioners 5

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": "1594512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757030400000",
    "number": "1861010266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696772",
            "telephone_number": "407-957-1337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 13TH ST",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696772",
            "telephone_number": "407-957-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL HEALTH CENTER OF CENTRAL FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-12",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A",
        "authorized_official_last_name": "TAKANEN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-957-1337"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2025; 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.