LIVE YOUNG PLLC (NPI# 1073962114) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073962114 |
| Entity Type | Organization |
| Organization Name | LIVE YOUNG PLLC |
| Other Organization Name | LIVE YOUNG CHIROPRACTIC |
| Practice Address |
1680 Sw Saint Lucie West Blvd Ste 204 Port St Lucie FL 34986-1927 |
| Mailing Address |
318 Se Fisk Rd Port St Lucie FL 34984-8920 |
| Practice Telephone | 7722121111 |
| Practice Fax Number | 7722120201 |
| Mailing Telephone | 8608835850 |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2019-02-12 |
| Authorized Official Name | DR. TIMOTHY M KENNEDY (OWNER) |
| Authorized Official Telephone | 7722121111 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
CH11346 | FL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Live Young Chiropractic | Doing Business As Name - Organization |
| Street Address |
1680 SW SAINT LUCIE WEST BLVD STE 204 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34986-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750787586 | Timothy Michael Kennedy | Chiropractor | 1680 Sw Saint Lucie West Blvd Ste 204, Port St Lucie, FL 34986 | 2014-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962992933 | Lindsay B Rojas | Occupational Therapist | 827 Sw Grand Reserves Blvd, Port St Lucie, FL 34986 | 2018-05-15 |
| 1639685266 | Natoya A Queenbourrows | Family Medicine | 2145 Nw Padova St, Port St Lucie, FL 34986 | 2017-12-19 |
| 1740634930 | The Toledo Clinic, LLC | Clinic/Center | 5481 Nw East Torino Parkway, Port St. Lucie, FL 34986 | 2016-04-14 |
| 1326407230 | Merline Smellie | Social Worker | 525 Nw Lake Whitney Place, Ste 102 & 103, Port St Lucie, FL 34986 | 2016-02-19 |
| 1124486949 | Therapy Connection of The Treasure Coast | Speech-Language Pathologist | 549 Nw Lake Whitney Pl Ste 104, Port St Lucie, FL 34986 | 2016-02-08 |
| 1689050015 | Yudelquis Comas Sanchez | Internal Medicine | Lawnwood Regional Medical Center, 1700 S 23rd St, Fort Pierce, FL 34986 | 2015-08-07 |
| 1689056889 | Joshua Chupp | Dentist | 1384 Sw St. Lucie West Blvd, Port St. Lucie, FL 34986 | 2015-06-24 |
| 1366821720 | Kids Therapy Solutions | Occupational Therapist | 161 Sw Palm Dr # 201, Port St Lucie, FL 34986 | 2015-05-19 |
| 1134514086 | Comfortable Care Dental Health Professionals, Pa | Dentist | 1384 Sw St. Lucie, Port St. Lucie, FL 34986 | 2015-03-30 |
| 1205249802 | Kacia Mcculloch | Social Worker | 525 Nw Lake Whitney Place Suites #102 & #103, Sequel Care of Florida, Port St Lucie, FL 34986 | 2014-06-11 |
| Find all providers in zip 34986 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1831718154 | Tc Physicians LLC | Clinic/Center | 1100 Sw Saint Lucie West Blvd Ste 209, Port St Lucie, FL 34986-1735 | 2020-04-16 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1750718896 | Mrdical Clinics Pa | Clinic/Center | 3700 Se Jennings Rd, Apt. 125, Port St Lucie, FL 34952-7701 | 2013-10-03 |
| 1831477553 | Treasure Coast Medical and Holistic Care, LLC | Clinic/Center | 1255 Sw Curry Street, Port St Lucie, FL 34983-2509 | 2011-07-29 |
| 1962707174 | Sudhir K Nayer Md & Assoc Pa | Clinic/Center | 8501 S Us Highway 1, Suite 10, Port St Lucie, FL 34952-3346 | 2011-01-19 |
| 1740301456 | Hassanein Clinic Inc | Clinic/Center | 437 Nw Prima Vista Blvd, Port St Lucie, FL 34983-8731 | 2007-04-02 |
| 1235674441 | Treasure Coast Healthcare Associates,llc | Clinic/Center | 6989 Hancock Dr, Port St Lucie, FL 34952-8207 | 2016-12-23 |
| 1952611352 | Executive Healthcare, Inc. | Clinic/Center | 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539 | 2010-10-19 |
| 1962677260 | Absolute Healthcare Advanced Chiropractic P A | Clinic/Center | 1973 Sw Savage Blvd, 111, Port St Lucie, FL 34953-2791 | 2008-04-28 |
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| 1548871866 | 1st Call Primary Care, LLC | Clinic/Center | 955 S Woodland Blvd Ste A1, Deland, FL 32720-7321 | 2020-08-11 |
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| 1104436492 | Caretinuum Health | Clinic/Center | 3208 W Lake Mary Blvd Ste 1710, Lake Mary, FL 32746-3467 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34986 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.