Organization Active NPI

Living Waters Hydration & Wellness LLC

  • Family Nurse Practitioner
  • Palm Harbor, FL
National Provider Identifier
1881412435
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
LIVING WATERS HYDRATION & WELLNESS LLC
Practice address
2000 Fishermens BND
Palm Harbor, FL 34685-2355
Phone
(813) 440-8599
NPI assigned
Oct 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

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

Authorized official

Name
Mrs. Juliana Mesa Martinez, APRNNPI 1669991659
Title
Owner/Nurse Practitioner
Phone
(727) 594-8463

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
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

2000 Fishermens BND
Palm Harbor, FL 34685-2355

Mailing address

2000 Fishermens BND
Palm Harbor, FL 34685-2355
Phone (813) 440-8599

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241121004022 FL Part B Supplier - Clinic/Group Practice 7214462613 Receives reassigned benefits from 2 practitioners
Practice locations: Palm Harbor, FL

National Provider Directory

National Provider Directory

Locations

8081 38th Ave N
St Petersburg, FL 33710
Phone (727) 209-2666

Practitioners & affiliated clinicians

Practitioners 2

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": "1727827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1881412435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 FISHERMENS BND",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852355",
            "telephone_number": "813-440-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 FISHERMENS BND",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346852355",
            "telephone_number": "813-440-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WATERS HYDRATION & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-02",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "MESA MARTINEZ",
        "authorized_official_first_name": "JULIANA",
        "authorized_official_title_or_position": "OWNER/NURSE PRACTITIONER",
        "authorized_official_telephone_number": "727-594-8463",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.