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Contact Information

LIVE WELL M.D.
11512 LAKE MEAD AVE
BUILDING 521
JACKSONVILLE, FL32256-9680
 Phone: 904-807-9747
 Fax: 904-807-9746
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for LIVE WELL M.D.

NPI Number 1992019640
LBN Legal business name LIVE WELL M.D.
Authorized official ALEX MOORE - (DOCTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 08/04/2010
Last updated 08/04/2010 - About 16 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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