I-Vita Hydration and Wellness Lounge LLC

Primary specialty

Infusion Therapy Clinic/CenterTaxonomy code 261QI0500X

Legal business name

I-VITA HYDRATION AND WELLNESS LOUNGE LLC

Practice address

425 Breckenridge Cir SE
Palm Bay, FL 32909-2341

Phone

(321) 215-8304

NPI assigned

Jun 21, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Miltiyia Blain, BSN, RN

Title

Owner

Phone

(321) 215-8304

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625184000000",
    "number": "1144899642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 BRECKENRIDGE CIR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329092341",
            "telephone_number": "321-215-8304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 BRECKENRIDGE CIR SE",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329092341",
            "telephone_number": "321-215-8304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I-VITA HYDRATION AND WELLNESS LOUNGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-21",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A",
        "authorized_official_last_name": "BLAIN",
        "authorized_official_first_name": "MILTIYIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "321-215-8304",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "BSN, RN"
    },
    "taxonomies": [
        {
            "code": "261QI0500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Infusion Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amy J Hunger
• Kelly Lindsay Hunt
• Patsy Ann Hyett, RN
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• Mohammad Idrees, M.D.
• III-D Therapy Services
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• Inez Gwendolyn Freeman, Robert Lee Freeman

• Infusion Therapy Clinic/Center in Palm Bay, FL
• Providers in Palm Bay, FL by specialty
• Infusion Therapy Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.