BLUELIFE MEDICAL INC NPI 1205706751

NPI Information

  • NPI: 1205706751
  • Provider Name: BLUELIFE MEDICAL, INC
  • Classification: Family Medicine - 207QP0002X
  • Specialization: Physician Nutrition Specialist
  • Entity Type: Organization
  • Address: 4850 TAMIAMI TRL N
    SUITE 301
    NAPLES, FL
    ZIP 34103
  • Phone: (239) 778-6958

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NPI Details

BLUELIFE MEDICAL, INC is a physician nutrition specialist medicine in Naples, FL. The provider is a physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquired errors of metabolism) and adjunctive nutritional therapeutics (e.g., nutritional therapy or support of diseases states with a metabolic component). Physician Nutrition Specialists also provide services for nutritional disease prevention, including diabetes, cancer, Alzheimer’s, hospital malnutrition screening, and perioperative nutrition. BLUELIFE MEDICAL, INC NPI is 1205706751. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4850 TAMIAMI TRL N
SUITE 301
NAPLES, FL
ZIP 34103-029
Phone: (239) 778-6958

The provider's authorized official is Jonathan L Corpus .
The authorized official title is Owner and has the following contact phone number (701) 818-7630.

The enumeration date for this NPI number is 11/10/2025 and was last updated on 11/10/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207QP0002XFamily MedicinePhysician Nutrition SpecialistYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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