Bluelife Medical, Inc

Primary specialty

Physician Nutrition Specialist (Family Medicine)Taxonomy code 207QP0002X

Legal business name

BLUELIFE MEDICAL, INC

Practice address

4850 Tamiami TRL N
Suite 301
Naples, FL 34103-3029

Phone

(239) 778-6958

NPI assigned

Nov 10, 2025

Last updated

Nov 10, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jonathan L Corpus, MD, MBA

Title

Owner

Phone

(701) 818-7630

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gianina Deleon Corpus, MD

  • Family Medicine Physician
  • Sparta, MI
  • NPI 1679987812

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1205706751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 TAMIAMI TRL N",
            "address_2": "SUITE 301",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033029",
            "telephone_number": "239-778-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 TAMIAMI TRL N",
            "address_2": "SUITE 301",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341033029",
            "telephone_number": "239-778-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUELIFE MEDICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-10-24",
        "status": "A",
        "authorized_official_last_name": "CORPUS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-818-7630",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "207QP0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Physician Nutrition Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Naples, FL
• Providers in Naples, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.