Organization Active NPI

Optimal Wellness Redefined, LLC

  • Chiropractor
  • Orange City, FL
National Provider Identifier
1932665668
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
OPTIMAL WELLNESS REDEFINED, LLC
Practice address
2765 Rebecca LN Ste D
Orange City, FL 32763-8326
Phone
(407) 901-7704
Fax
(407) 288-8582
NPI assigned
Feb 19, 2019
Last updated
Sep 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Authorized official

Name
Larisa Susan ScottNPI 1467857037
Title
Owner
Phone
(407) 901-7704

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

2765 Rebecca LN Ste D
Orange City, FL 32763-8326

Mailing address

7560 Red Bug Lake Road
Suite #1080
Oviedo, FL 32765-6601
Phone (407) 901-7704

Other practice location 1

7560 Red Bug Lake Road
Suite #1080
Oviedo, FL 32765-6601
Phone (407) 901-7704

National Provider Directory

National Provider Directory

Locations

1100 Town Plaza Ct
Ste 1020
Winter Springs, FL 32708
Phone (407) 901-7704

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1932665668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7560 RED BUG LAKE ROAD",
            "address_2": "SUITE #1080",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656601",
            "telephone_number": "407-901-7704",
            "fax_number": "407-288-8582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2765 REBECCA LN STE D",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327638326",
            "telephone_number": "407-901-7704",
            "fax_number": "407-288-8582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7560 Red Bug Lake Road",
            "address_2": "Suite #1080",
            "address_purpose": "LOCATION",
            "city": "Oviedo",
            "state": "FL",
            "postal_code": "327656601",
            "country_code": "US",
            "telephone_number": "407-901-7704",
            "fax_number": "407-288-8582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OPTIMAL WELLNESS REDEFINED, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-19",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "LARISA",
        "authorized_official_middle_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-901-7704"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.