Healthcare Provider Details

I. General information

NPI: 1780596965
Provider Name (Legal Business Name): CAPITAL LIFESTYLE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 NW 15TH PL
CAPE CORAL FL
33993-6032
US

IV. Provider business mailing address

1231 NW 15TH PL
CAPE CORAL FL
33993-6032
US

V. Phone/Fax

Practice location:
  • Phone: 786-406-9860
  • Fax:
Mailing address:
  • Phone: 786-406-9860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: WENDY GOMEZ
Title or Position: OWNER
Credential:
Phone: 786-406-9860