Excellife Integrative Care, Corp.

Primary specialty

Integrative Medicine PhysicianTaxonomy code 202D00000X

Legal business name

EXCELLIFE INTEGRATIVE CARE, CORP.

Practice address

4774 US Highway 19
New Port Richey, FL 34652-4944

Phone

(727) 297-9779

NPI assigned

Jan 13, 2023

Last updated

Nov 24, 2023By 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

Ariel Diaz

Title

President/Administrator

Phone

(727) 312-4042

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1673568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700784000000",
    "number": "1780399733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4772 US HIGHWAY 19",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524944",
            "telephone_number": "727-297-9779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4774 US HIGHWAY 19",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346524944",
            "telephone_number": "727-297-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELLIFE INTEGRATIVE CARE, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-13",
        "last_updated": "2023-11-24",
        "certification_date": "2023-01-13",
        "status": "A",
        "authorized_official_last_name": "DIAZ",
        "authorized_official_first_name": "ARIEL",
        "authorized_official_title_or_position": "PRESIDENT/ADMINISTRATOR",
        "authorized_official_telephone_number": "727-312-4042"
    },
    "taxonomies": [
        {
            "code": "202D00000X",
            "taxonomy_group": "",
            "desc": "Integrative Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.hormonesconnection.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4774 US Highway 19",
            "city": "New Port Richey",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346524944",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2023; 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.