Provider Demographics
NPI:1912583816
Name:TRANSCEND PERFORMANCE AND LIFESTYLE INSTITUTE
Entity Type:Organization
Organization Name:TRANSCEND PERFORMANCE AND LIFESTYLE INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-544-0166
Mailing Address - Street 1:17425 7TH ST STE 5601274
Mailing Address - Street 2:
Mailing Address - City:MONTVERDE
Mailing Address - State:FL
Mailing Address - Zip Code:34756-3235
Mailing Address - Country:US
Mailing Address - Phone:407-544-0166
Mailing Address - Fax:407-543-6537
Practice Address - Street 1:17425 7TH ST STE 5601274
Practice Address - Street 2:
Practice Address - City:MONTVERDE
Practice Address - State:FL
Practice Address - Zip Code:34756-3235
Practice Address - Country:US
Practice Address - Phone:407-544-0166
Practice Address - Fax:407-543-6537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty