NPIMap

Organization Active NPI

Life Wellness Group

  • Chiropractor
  • Miami Lakes, FL
National Provider Identifier
1952178345
Registry record updated Dec 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LIFE WELLNESS GROUP
Practice address
14261 Commerce Way Ste 203
Miami Lakes, FL 33016-1647
Phone
(305) 698-4000
Fax
(305) 698-4014
NPI assigned
Dec 6, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2023

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

Authorized official

Name
Gary Robertson, DC
Title
Owner
Phone
(305) 698-4000

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Orthopedic ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NX0800X
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X

Addresses

Primary practice location

14261 Commerce Way Ste 203
Miami Lakes, FL 33016-1647

Mailing address

14261 Commerce Way Ste 203
Miami Lakes, FL 33016-1647
Phone (305) 698-4000

National Provider Directory

National Provider Directory

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": "1701820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1952178345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14261 COMMERCE WAY STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161647",
            "telephone_number": "305-698-4000",
            "fax_number": "305-698-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14261 COMMERCE WAY STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161647",
            "telephone_number": "305-698-4000",
            "fax_number": "305-698-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE WELLNESS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-06",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-698-4000",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

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