Provider Demographics
NPI:1306630652
Name:MEDLIFE HEALTH SERVICES LLC
Entity type:Organization
Organization Name:MEDLIFE HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LILIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:FROMETA ALEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:832-265-4388
Mailing Address - Street 1:2996 SW BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3207
Mailing Address - Country:US
Mailing Address - Phone:832-265-4388
Mailing Address - Fax:
Practice Address - Street 1:2996 SW BRIDGE ST
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-3207
Practice Address - Country:US
Practice Address - Phone:832-265-4388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty