Healthcare Provider Details

I. General information

NPI: 1891617056
Provider Name (Legal Business Name): RELIFE REGENERATIVE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 WILES RD STE 104
CORAL SPRINGS FL
33067-2038
US

IV. Provider business mailing address

7401 WILES RD STE 104
CORAL SPRINGS FL
33067-2038
US

V. Phone/Fax

Practice location:
  • Phone: 954-545-3433
  • Fax: 855-552-3776
Mailing address:
  • Phone: 954-545-3433
  • Fax: 855-552-3776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA MERKOW
Title or Position: BUSINESS MANAGER
Credential:
Phone: 727-800-9958