Provider Demographics
NPI:1285189431
Name:NUVIDA HOLISTIC MEDICINE LLC
Entity Type:Organization
Organization Name:NUVIDA HOLISTIC MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIBEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, AP
Authorized Official - Phone:321-696-1581
Mailing Address - Street 1:2431 ALOMA AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2541
Mailing Address - Country:US
Mailing Address - Phone:321-696-1581
Mailing Address - Fax:
Practice Address - Street 1:2431 ALOMA AVE
Practice Address - Street 2:SUITE #107
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-2541
Practice Address - Country:US
Practice Address - Phone:321-696-1581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3665261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center