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Organization

BLUELIFE MEDICAL, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JONATHAN L CORPUS MD, MBA (OWNER)
(701) 818-7630
Entity
Organization

Contact information

Practice address
4850 TAMIAMI TRL N, SUITE 301, NAPLES, FL 34103-3029
(239) 778-6958
Mailing address
4850 TAMIAMI TRL N, SUITE 301, NAPLES, FL 34103-3029
(239) 778-6958

Taxonomy

Speciality
Code
Description
License number
State
207QP0002X
Physician Nutrition Specialist (Family Medicine)
Primary

Other

Enumeration date
11/10/2025
Last updated
11/10/2025
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