Central Florida Concussion Institute LLC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

CENTRAL FLORIDA CONCUSSION INSTITUTE LLC

Practice address

305 Main St Ste B
Auburndale, FL 33823-4113

Phone

(863) 247-8267

Fax

(863) 247-8269

NPI assigned

Jul 25, 2019

Last updated

Nov 27, 2023By 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

Angela Westmoreland

Title

Owner, Clinic Director

Phone

(863) 247-8267

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1564012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1891349171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 MAIN ST STE B",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338234113",
            "telephone_number": "863-247-8267",
            "fax_number": "863-247-8269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MAIN ST STE B",
            "city": "AUBURNDALE",
            "state": "FL",
            "postal_code": "338234113",
            "telephone_number": "863-247-8267",
            "fax_number": "863-247-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL FLORIDA CONCUSSION INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-25",
        "last_updated": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "WESTMORELAND",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER, CLINIC DIRECTOR",
        "authorized_official_telephone_number": "863-247-8267"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@restorativephysicalmedicine.com",
            "affiliation": "Y",
            "affiliationName": "FAMILY SPINE & SPORTS THERAPY LLC",
            "address_1": "305 Main St Ste B",
            "city": "Auburndale",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338234113",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.