Bluelife Medical, INC
Family Medicine, Physician Nutrition Specialist in Naples, FL. Organization (NPI-2).
NPI number1205706751
StatusActive
Last updated in NPPESNov 10, 2025
Details
- NPI
- 1205706751
- Entity type
- Organization (NPI-2)
- Legal business name
- Bluelife Medical, INC
- Organization subpart
- No
- Enumeration date
- Nov 10, 2025
- Certification date
- Oct 24, 2025
- Last updated
- Nov 10, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QP0002X | Family Medicine, Physician Nutrition Specialist | – | – | Yes |
Practice location
4850 Tamiami Trl NSuite 301
Naples, FL 34103-3029
Phone 239-778-6958
Mailing address
4850 Tamiami Trl NSuite 301
Naples, FL 34103-3029
Phone 239-778-6958
Authorized official
Jonathan L Corpus
Owner
7018187630
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