Active NPI
Vida Functional Wellness PLLC
- Primary Care Nurse Practitioner
- Valrico, FL
National Provider Identifier
1083589691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- VIDA FUNCTIONAL WELLNESS PLLC
- Practice address
- 3530 Autumn Glen Dr
Valrico, FL 33596-8269 - Phone
- (813) 586-0901
- NPI assigned
- Oct 6, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Felipe M Silva
- Title
- Co-Founder
- Phone
- (813) 586-0901
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
3530 Autumn Glen Dr
Valrico, FL 33596-8269
Mailing address
3530 Autumn Glen Dr
Valrico, FL 33596-8269
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Temple Terrace, FL
- NPI 1619371051
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1759708800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759708800000",
"number": "1083589691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3530 AUTUMN GLEN DR",
"city": "VALRICO",
"state": "FL",
"postal_code": "335968269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3530 AUTUMN GLEN DR",
"city": "VALRICO",
"state": "FL",
"postal_code": "335968269",
"telephone_number": "813-586-0901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIDA FUNCTIONAL WELLNESS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-06",
"last_updated": "2025-10-06",
"certification_date": "2025-10-06",
"status": "A",
"authorized_official_last_name": "SILVA",
"authorized_official_first_name": "FELIPE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "CO-FOUNDER",
"authorized_official_telephone_number": "813-586-0901"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Valrico, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.