Living Water Wellness Center, LLC is a Primary Care Clinic/Center (organization) practicing in Ft Lauderdale, Florida. The National Provider Identifier (NPI) is #1134991177, which was assigned on October 24, 2023, and the registration record was last updated on October 28, 2025. The practitioner's main practice location is at 2400 E Commercial Blvd Ste 218, Ft Lauderdale, FL 33308-4022; the contact telephone number is 3053346163, and the fax number is 7865133811. The primary taxonomy of Living Water Wellness Center, LLC is Primary Care Clinic/Center (261QP2300X), with specialization in Primary Care. The authorized official for Living Water Wellness Center, LLC is Alejandro Perez (Provider Manager).
| NPI | 1134991177 |
| Entity Type | Organization |
| Organization Name | LIVING WATER WELLNESS CENTER, LLC |
| Provider Name | LIVING WATER WELLNESS CENTER, LLC |
| Practice Address |
2400 E Commercial Blvd Ste 218 Ft Lauderdale FL 33308-4022 |
| Practice Telephone | 3053346163 |
| Practice Fax Number | 7865133811 |
| Mailing Address |
13762 W State Road 84 # 95 Davie FL 33325-5305 |
| Mailing Telephone | 3053346163 |
| Mailing Fax Number | 7865133811 |
| Certification Date | 2025-10-28 |
| Enumeration Date | 2023-10-24 |
| Last Update Date | 2025-10-28 |
| Is Organization Subpart | N |
| Official Name | ALEJANDRO PEREZ |
| Official Title | PROVIDER MANAGER |
| Credential | APRN |
| Telephone | 3059053042 |
| Primary | Code | Classification | Specialization | Taxonomy Group | License Number | License State |
|---|---|---|---|---|---|---|
| Y | 261QP2300X | Clinic/Center | Primary Care |
| Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Grouping | Ambulatory Health Care Facilities |
| Definition: Definition to come... |
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|---|---|---|---|
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| Hardt Health PLLC | 7701 N Highway 171 Ste G, Godley, TX 76044-4215 | Primary Care Clinic/Center | 2026-05-07 |
| Prosperity Medical Clinical Group | 186 N Main St Fl 2, Plymouth, MI 48170-1236 | Primary Care Clinic/Center | 2026-05-08 |
| Ogiso Health PLLC | 2700 Gallatin Pike Ste D, Nashville, TN 37216-3702 | Primary Care Clinic/Center | 2026-05-06 |
| Jakae Wellness LLC | 3324 Peachtree Rd Ne Unit 1114, Atlanta, GA 30326-1475 | Primary Care Clinic/Center | 2026-05-07 |
| Clearlane Behavioral Health LLC | 2780 E Fowler Ave # 601, Tampa, FL 33612-6297 | Primary Care Clinic/Center | 2026-05-06 |
| Zeus Medical Center LLC | 330 Sw 27th Ave Ste 702, Miami, FL 33135-2968 | Primary Care Clinic/Center | 2026-05-08 |
| Clovis Pediatric Group | 726 N Medical Center Dr E, Clovis, CA 93611-6881 | Primary Care Clinic/Center | 2026-05-08 |
| Quickcare Virtual Clinic LLC | 13833 Emerson Dr, Hagerstown, MD 21742-5322 | Primary Care Clinic/Center | 2026-05-06 |
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| Street Address |
13762 W STATE ROAD 84 # 95 |
| City | DAVIE |
| State | FL |
| Zip Code | 33325-5305 |
| Country | US |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| James Walter Lofton III | 13762 W State Road 84 Ste 136, Davie, FL 33325-5305 | Family Medicine Physician | 2020-02-03 |
| Clear Image Group Inc | 13762 W State Road 84, Suite198, Davie, FL 33325-5305 | Mobile Radiology Clinic/Center | 2014-08-16 |
| Elizabeth M Valme · Elizabeth M Rene | 13762 W State Road 84, Pmb#403, Davie, FL 33325-5305 | Dentist | 2008-06-02 |
| Provider Name | Address | Taxonomy | Enumeration Date |
|---|---|---|---|
| Veronica Ivonne Franco-Saavedra | 701 Sw 148th Ave Apt 101, Davie, FL 33325 | Surgical Assistant | 2017-06-18 |
| Susana Potter | 11913 Sw 13th Ct, Davie, FL 33325 | Mental Health Counselor | 2018-08-13 |
| Wayne Goldman | 12960 West State Road 84, Davie, FL 33325 | Ophthalmic Technician/Technologist | 2015-10-28 |
| Edinson Antonio Matos-Moreno | 705 Sw 148th Ave Apt 202, Davie, FL 33325 | Surgical Physician Assistant | 2017-06-11 |
| Gabriela Avila- Garcia | 440 Sawgrass Corporate Parkway Suite 106, Sunrise, FL 33325 | Behavior Technician | 2020-07-27 |
| Scott Rosiere | 480 West Mount Vernon Drive, Plantation, FL 33325 | Clinical Psychologist | 2017-05-04 |
| Hc Surgical LLC | 11352 W State Road 84 Unit 1, Davie, FL 33325 | Surgical Physician Assistant | 2017-07-31 |
| Chasidy Ruiz | 13650 Nw 8th Street Suite 109, Sunrise, FL 33325 | Behavior Technician | 2021-10-03 |
| Allie Maryjane Pandiscio | 13650 Nw Eighth St, Unit 109, Sunrise, FL 33325 | Behavior Technician | 2021-09-24 |
| Veredy S.A.S LLC | 705 Sw 148 Av Apt 202, Davie, FL 33325 | Surgical Assistant | 2017-07-12 |
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| Rest & Restore Living Rehab Center Inc | 11574 Yarmouth Ave, Granada Hills, CA 91344-2158 | Substance Abuse Rehabilitation Facility | 2026-05-04 |
| Water Pig Wellness PLLC | 1283 E Ogden Ave Ste 101, Naperville, IL 60563-4803 | Acupuncturist | 2026-03-13 |
| I Am Whole Wellness Center, LLC | 5405 Memorial Dr Bldg C, Stone Mountain, GA 30083-3234 | Public Health & General Preventive Medicine Physician | 2026-04-20 |
| Renees Assisting Living Center LLC | 6615 N 85th St, Milwaukee, WI 53224-5413 | Assisted Living Facility (Mental Illness) | 2026-03-04 |
| Pioneer Living Center Ops LLC | 623 S Alabama St, Wetumka, OK 74883-6034 | Intellectual Disabilities Intermediate Care Facility | 2026-04-27 |
| Pioneer Living Center Ops LLC | 620 S Alabama St, Wetumka, OK 74883-6033 | Intellectual Disabilities Intermediate Care Facility | 2026-04-27 |
| Abundant Living Health & Wellness Resulting Services, Inc. | 1550 Nw 3rd Ave, Miami, FL 33136-1827 | Mental Health Clinic/Center (Including Community Mental Health Center) | 2026-04-22 |
| Pioneer Living Center Ops LLC | 202 E 1st St, Wetumka, OK 74883-6041 | Intellectual Disabilities Intermediate Care Facility | 2026-04-27 |
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This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.
| Subject | Transparency and Disclosure |
| Jurisdiction | Federal |
| Data Provider | National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS) |
| Source | download.cms.gov |
The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number). All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid). Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008. This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information. |