ANTI-AGING MEDICAL CENTER NPI 1265795207

NPI Information

  • NPI: 1265795207
  • Provider Name: ANTI-AGING MEDICAL CENTER
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: RESTORATIVE MEDICAL CENTER
  • CLIA Number: 10D2064947
  • Address: 3545 BOBCAT VILLAGE CENTER RD
    NORTH PORT, FL
    ZIP 34288
  • Phone: (941) 625-0304

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NPI Details

ANTI-AGING MEDICAL CENTER is a family nurse practitioner in North Port, FL. ANTI-AGING MEDICAL CENTER NPI is 1265795207. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Restorative Medical Center.

The provider's business location address is:

3545 BOBCAT VILLAGE CENTER RD
NORTH PORT, FL
ZIP 34288-977
Phone: (941) 625-0304

The provider's authorized official is Christina M Parker .
The authorized official title is Owner/arnp and has the following contact phone number (316) 207-3406.

The CLIA number assigned to this NPI record is 10D2064947 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/22/2012 and was last updated on 6/22/2012.

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
1363LF0000XNurse PractitionerFamily9267806FLORIDAYes

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

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