Vaxonsite, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

License

HCC10745 Issued in FL

Legal business name

VAXONSITE, LLC

Practice address

1434 Jam LN
Odessa, FL 33556-3704

Phone

(727) 489-4358

Fax

(813) 342-7934

NPI assigned

Sep 16, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Sean P Curtin

Title

President/Cfo

Phone

(727) 489-4358

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Casey O'Donnell, D.O., MBA

  • Physical Medicine & Rehabilitation Physician
  • Hingham, MA
  • NPI 1922062157

  FL

  Medicare reassignment NPD
• Ronald Fred Stacey II, D.C.

  • Chiropractor
  • Trinity, FL
  • NPI 1285658104
  NPD (past)

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

{
    "created_epoch": "1473984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473984000000",
    "number": "1982152054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1166",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335561051",
            "telephone_number": "727-489-4358",
            "fax_number": "813-342-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1434 JAM LN",
            "city": "ODESSA",
            "state": "FL",
            "postal_code": "335563704",
            "telephone_number": "727-489-4358",
            "fax_number": "813-342-7934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAXONSITE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-16",
        "last_updated": "2016-09-16",
        "status": "A",
        "authorized_official_last_name": "CURTIN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT/CFO",
        "authorized_official_telephone_number": "727-489-4358",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "FL",
            "license": "HCC10745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA - HEALTH CARE CLINIC LICENSE # HCC10745",
            "identifier": "HCC10745",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Michael Tumolo
• Cherrell Turley, OTA
• U Thrive
• Lindsey Valancius
• Valora Living Services LLC
• Lito B Villanueva, PT
• Onier Villarreal Alejandro, M.D.
• Natricia Wade
• Karyn Walters
• Kimberly Walters

• Multi-Specialty Clinic/Center in Odessa, FL
• Providers in Odessa, FL by specialty
• Multi-Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.