Healthcare Provider Details

I. General information

NPI: 1215845466
Provider Name (Legal Business Name): VITA WELLNESS BY CJ
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 NE 34TH ST APT 908
MIAMI FL
33137-4055
US

IV. Provider business mailing address

555 NE 34TH ST APT 908
MIAMI FL
33137-4055
US

V. Phone/Fax

Practice location:
  • Phone: 786-622-0761
  • Fax:
Mailing address:
  • Phone: 786-622-0761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code364SH1100X
TaxonomyHolistic Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: CLARIANNE IRALIS JIMENEZ
Title or Position: CEO
Credential: PHD
Phone: 305-967-1518