Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
THE CENTER FOR FUNCTIONAL AESTHETIC AND ANTI AGING MEDICINE INC
Active
Organization
THE CENTER FOR FUNCTIONAL AESTHETIC AND ANTI AGING MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANICE BLAISE MD, MBA (CHIEF EXECUTIVE OFFICER, OWNER)
(954) 681-0068
Entity
Organization
Contact information
Practice address
571 AVENUE K SE, WINTER HAVEN, FL 33880-4215
(407) 440-0708
Mailing address
571 AVENUE K SE, WINTER HAVEN, FL 33880-4215
(407) 440-0708
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
—
—
Other
Enumeration date
11/29/2024
Last updated
11/29/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up