Optimal Wellness & Longevity Institute, LLC

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

ME 53688 Issued in FL

Legal business name

OPTIMAL WELLNESS & LONGEVITY INSTITUTE, LLC

Practice address

875 Military TRL
Suite 105
Jupiter, FL 33458-5700

Phone

(561) 803-8407

NPI assigned

Nov 6, 2015

Organization subpart

No

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

Authorized official

Name

Harvey Montijo, M.D.

Title

Ceo

Phone

(561) 803-8407

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1446768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446768000000",
    "number": "1912370321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 MILITARY TRL",
            "address_2": "SUITE 105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585700",
            "telephone_number": "561-803-8407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MILITARY TRL",
            "address_2": "SUITE 105",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334585700",
            "telephone_number": "561-803-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL WELLNESS & LONGEVITY INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-06",
        "last_updated": "2015-11-06",
        "status": "A",
        "authorized_official_last_name": "MONTIJO",
        "authorized_official_first_name": "HARVEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-803-8407",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME 53688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopaedic Surgery Physician in Jupiter, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.