Healthcare Provider Details

I. General information

NPI: 1548700115
Provider Name (Legal Business Name): I AM HEALTHY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2017
Last Update Date: 04/12/2021
Certification Date: 04/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N PARK AVE STE 201
APOPKA FL
32703-4147
US

IV. Provider business mailing address

201 N PARK AVE STE 201
APOPKA FL
32703-4147
US

V. Phone/Fax

Practice location:
  • Phone: 407-814-2680
  • Fax: 407-814-2068
Mailing address:
  • Phone: 407-814-2680
  • Fax: 407-814-2068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME87564
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberME 87564
License Number StateFL

VIII. Authorized Official

Name: DR. JASON LAMONT SALAGUBANG
Title or Position: D.O./OWNER
Credential: M.D.
Phone: 407-814-2680