LIVE YOUNG PLLC NPI 1073962114

NPI Information

  • NPI: 1073962114
  • Provider Name: LIVE YOUNG PLLC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: LIVE YOUNG CHIROPRACTIC
  • Address: 1680 SW SAINT LUCIE WEST BLVD STE 204
    PORT ST LUCIE, FL
    ZIP 34986
  • Phone: (772) 212-1111

Map and Directions

Get Directions

NPI Details

LIVE YOUNG PLLC is a primary care clinic center in Port St Lucie, FL. LIVE YOUNG PLLC NPI is 1073962114. The provider is registered as an organization entity type.
The provider Is Doing Business As Live Young Chiropractic.

The provider's business location address is:

1680 SW SAINT LUCIE WEST BLVD STE 204
PORT ST LUCIE, FL
ZIP 34986-927
Phone: (772) 212-1111
Fax: (772) 212-0201

The provider's authorized official is Timothy M Kennedy .
The authorized official title is Owner and has the following contact phone number (772) 212-1111.

The enumeration date for this NPI number is 6/9/2016 and was last updated on 2/12/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareCH11346FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI