Metavida LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

METAVIDA LLC

Practice address

701 Old Dixie Hwy
Tequesta, FL 33469-2493

Phone

(561) 523-8887

NPI assigned

Apr 25, 2024

Last updated

Apr 25, 2024By 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

Dr. Tammy Malloy, PHD, LCSW, CSATNPI 1538634472

Title

Chief Operating Officer

Phone

(561) 376-9790

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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.

• Tammy Cheever Malloy

  • Clinical Social Worker
  • Boca Raton, FL
  • NPI 1538634472
  Authorized official Same address or phone

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1982450540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 OLD DIXIE HWY",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692493",
            "telephone_number": "561-523-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 OLD DIXIE HWY",
            "city": "TEQUESTA",
            "state": "FL",
            "postal_code": "334692493",
            "telephone_number": "561-523-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METAVIDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "MALLOY",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "561-376-9790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LCSW, CSAT"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J McPherson, LMHC
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• Medical Diagnostic Network, Inc.
• Medical Supply Shoppe of the Palm Beaches Inc.
• Miami Circle Labs LLC
• Michael David Lukens, PHD., PA
• John D Miller, D.D.S, P.A
• Ann M Morris, LMT
• Jutta Maria Morris, MA

• Adult Mental Health Clinic/Center in Tequesta, FL
• Providers in Tequesta, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.