Healthcare Provider Details

I. General information

NPI: 1003721119
Provider Name (Legal Business Name): ONELIFE WELLNESS CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15771 SW 136TH TER
MIAMI FL
33196-1838
US

IV. Provider business mailing address

15771 SW 136TH TER
MIAMI FL
33196-1838
US

V. Phone/Fax

Practice location:
  • Phone: 954-910-7572
  • Fax:
Mailing address:
  • Phone: 954-910-7572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AARON JAY LOVERA
Title or Position: MANAGING MEMBER
Credential:
Phone: 305-834-9095