Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Live Well MD

Organization Preferred Provider Organization · NPI 1992019640

Live Well MD is a Preferred Provider Organization in Jacksonville, Florida. Registered with an NPI since 2010.

In the registry since
2010

Practice location Address checks out

11512 Lake Mead Ave Bldg 521
Jacksonville, FL 32256-9680
Phone: (904) 807-9747
Fax: (904) 807-9746
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Preferred Provider Organization (primary) Taxonomy 305R00000X

Record details

NPI number1992019640
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alex Moore — Doctor · (904) 807-9747
NPI enumeratedAugust 4, 2010
Last updated in NPPESAugust 4, 2010
Mailing address11512 Lake Mead Ave, Building 521, Jacksonville, FL 32256-9680

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