TOTAL BACK AND BODY CENTER, PLLC (NPI# 1710298666) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710298666 |
| Entity Type | Organization |
| Organization Name | TOTAL BACK AND BODY CENTER, PLLC |
| Practice Address |
1228 Se Port St Lucie Blvd Port St Lucie FL 34952-5330 |
| Practice Telephone | 7728789355 |
| Practice Fax Number | 7723984988 |
| Mailing Telephone | 7728789355 |
| Mailing Fax Number | 7723984988 |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-10-06 |
| Authorized Official Name | DR. KELLY M MEREDITH (OWNER) |
| Authorized Official Telephone | 7728789355 |
| Authorized Official Credential | DC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
CH0006729 | FL | Ambulatory Health Care Facilities |
| Street Address |
1228 SE PORT ST LUCIE BLVD |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34952-5330 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790846020 | The Doctors Shoe Store | Durable Medical Equipment & Medical Supplies | 1228 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5330 | 2006-12-12 |
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|---|---|---|---|---|
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| 1255998274 | Morningside Alf | Assisted Living Facility | 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 | 2019-05-24 |
| 1336611870 | Med Braces and Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1484 Se Village Green Dr, Port St Lucie, FL 34952 | 2018-12-21 |
| 1689143794 | The Gift of Recovery, LLC | Counselor | 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 | 2018-11-19 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1548756661 | Blo 7 Diabetes Institute Inc | Nutritionist | 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 | 2018-07-02 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1801305644 | Thandiwe Daley | Behavior Technician | 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 | 2017-09-25 |
| 1700309408 | Lagrand Evan Andrews | Assistant Behavior Analyst | 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 | 2017-07-25 |
| 1578085148 | Lavetta S Ivey | Behavior Technician | 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 | 2017-07-14 |
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| Taxonomy Code | 261QH0100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Health Service |
| Definition to come... |
| Notes: [7/1/2006: modified title] |
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|---|---|---|---|---|
| 1417205147 | Hands On Performance LLC | Clinic/Center | 1430 Sw Saint Lucie West Blvd, Suite 103, Port St Lucie, FL 34986-2134 | 2012-08-28 |
| 1649466384 | Lucille A Vandevere, LLC | Clinic/Center | 6989 Hancock Dr, Port St Lucie, FL 34952-8207 | 2007-09-17 |
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| City | PORT ST LUCIE |
| Zip Code | 34952 |
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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.