# ELITE LIFE SCIENCES LLC

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

## Provider details

- **NPI number:** 1457822793
- **Authorized official:** MICHAEL CARBONARA (MANAGER)
- **Authorized official phone:** (305) 741-0171

## Contact information

- **Practice address:** 78 SW 7TH ST \# 6-114, MIAMI, FL 33130-3402
- **Practice address phone:** (305) 741-0171
- **Mailing address:** 102 NE 2ND ST STE 112, BOCA RATON, FL 33432-3908
- **Mailing address phone:** (305) 741-0171

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 335G00000X | Medical Foods Supplier | — | NULL | Yes |

## Other

- **Enumeration date:** 12/16/2018
- **Last updated:** 12/16/2018