Bluelife Wellness, LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

BLUELIFE WELLNESS, LLC

Practice address

18033 Promenade Park LN Apt 203
Lutz, FL 33548-7980

Phone

(813) 409-1910

NPI assigned

Aug 24, 2023

Organization subpart

No

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

Authorized official

Name

Donisha Taylor

Title

Ambr

Phone

(813) 409-1910

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1932983301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18033 PROMENADE PARK LN APT 203",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335487980",
            "telephone_number": "813-409-1910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18033 PROMENADE PARK LN APT 203",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335487980",
            "telephone_number": "813-409-1910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUELIFE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "DONISHA",
        "authorized_official_title_or_position": "AMBR",
        "authorized_official_telephone_number": "813-409-1910"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Lutz, FL
• Providers in Lutz, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

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