Living Water Wellness Center, LLC · Primary Care Clinic/Center

13762 W State Road 84 # 95, Davie, FL 33325-5305

Overview

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).

Provider Information

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

Authorized Official Information

Official Name ALEJANDRO PEREZ
Official Title PROVIDER MANAGER
Credential APRN
Telephone 3059053042

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
Y261QP2300XClinic/CenterPrimary Care

Taxonomy Information

Primary Taxonomy

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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Location Information

Street Address 13762 W STATE ROAD 84 # 95
City DAVIE
State FL
Zip Code 33325-5305
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
James Walter Lofton III 13762 W State Road 84 Ste 136, Davie, FL 33325-5305Family Medicine Physician2020-02-03
Clear Image Group Inc 13762 W State Road 84, Suite198, Davie, FL 33325-5305Mobile Radiology Clinic/Center2014-08-16
Elizabeth M Valme · Elizabeth M Rene 13762 W State Road 84, Pmb#403, Davie, FL 33325-5305Dentist2008-06-02

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Veronica Ivonne Franco-Saavedra 701 Sw 148th Ave Apt 101, Davie, FL 33325Surgical Assistant2017-06-18
Susana Potter 11913 Sw 13th Ct, Davie, FL 33325Mental Health Counselor2018-08-13
Wayne Goldman 12960 West State Road 84, Davie, FL 33325Ophthalmic Technician/Technologist2015-10-28
Edinson Antonio Matos-Moreno 705 Sw 148th Ave Apt 202, Davie, FL 33325Surgical Physician Assistant2017-06-11
Gabriela Avila- Garcia 440 Sawgrass Corporate Parkway Suite 106, Sunrise, FL 33325Behavior Technician2020-07-27
Scott Rosiere 480 West Mount Vernon Drive, Plantation, FL 33325Clinical Psychologist2017-05-04
Hc Surgical LLC 11352 W State Road 84 Unit 1, Davie, FL 33325Surgical Physician Assistant2017-07-31
Chasidy Ruiz 13650 Nw 8th Street Suite 109, Sunrise, FL 33325Behavior Technician2021-10-03
Allie Maryjane Pandiscio 13650 Nw Eighth St, Unit 109, Sunrise, FL 33325Behavior Technician2021-09-24
Veredy S.A.S LLC 705 Sw 148 Av Apt 202, Davie, FL 33325Surgical Assistant2017-07-12
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Dataset Information

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

Dataset Details

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.