Healthcare Provider Details

I. General information

NPI: 1952238503
Provider Name (Legal Business Name): D DIVINE SERENITY LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3518 ASPIRE CIR APT 5409
CAPE CORAL FL
33914-5595
US

IV. Provider business mailing address

3518 ASPIRE CIR APT 5409
CAPE CORAL FL
33914-5595
US

V. Phone/Fax

Practice location:
  • Phone: 239-990-1464
  • Fax:
Mailing address:
  • Phone: 239-990-1464
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name: LIDIA D POLO
Title or Position: OWNER
Credential:
Phone: 239-990-1464