# GOODLIFE CARDIAC CARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104536853
- **Authorized official:** LAQUETA NELSON NP (OWNER/PROVIDER)
- **Authorized official phone:** (770) 383-1415

## Contact information

- **Practice address:** 2400 HERODIAN WAY SE STE 220, SMYRNA, GA 30080-8500
- **Practice address phone:** (770) 383-1415
- **Mailing address:** 2400 HERODIAN WAY SE STE 220, SMYRNA, GA 30080-8500
- **Mailing address phone:** (770) 383-1415

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/02/2022
- **Last updated:** 12/02/2022