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NPI Code Detail

MEDICARE: MYLYFE HEALTH MA PC

MEDICARE: MYLYFE HEALTH MA PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist
2261QI0500XInfusion Therapy Clinic/Center

General Provider Information

NPI Number : 1053107227
Entity Type Code : Organization
Provider Name (Legal Business Name) : MYLYFE HEALTH MA PC
Provider Business Mailing Address
First Line : PO BOX 931733
Second Line :
City : ATLANTA
State : GA
Zip : 31193-1733
Country : US
Telephone Number : 888-232-3120
Fax Number : 888-865-1231
Provider Business Practice Location Address
First Line : 145 WARD HILL AVE STE 100
Second Line :
City : HAVERHILL
State : MA
Zip : 01835-6928
Country : US
Telephone Number : 844-469-5933
Fax Number :
Authorized Official
Title or Position : PRESIDENT, TREASURER, SECRETARY
Name : MICHAEL L BLUTE SR.
Credential : MD
Telephone Number : 888-232-3120
Provider Enumeration Date : 04/15/2025
Last Update Date : 05/16/2026

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