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

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• 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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• Physician Nutrition Specialist (Family Medicine) in Naples, FL
• Providers in Naples, FL by specialty
• Physician Nutrition Specialist (Family Medicine) 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.