Provider Demographics
NPI:1720850944
Name:CLINIC LA VIDA IS BEAUTIFUL LLC
Entity Type:Organization
Organization Name:CLINIC LA VIDA IS BEAUTIFUL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:NIUVYS
Authorized Official - Middle Name:NUNEZ
Authorized Official - Last Name:CARDET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-568-3756
Mailing Address - Street 1:1748 51ST ST SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-5636
Mailing Address - Country:US
Mailing Address - Phone:561-568-3756
Mailing Address - Fax:
Practice Address - Street 1:1748 51ST ST SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34116-5636
Practice Address - Country:US
Practice Address - Phone:561-568-3756
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care