Healthcare Provider Details

I. General information

NPI: 1366690224
Provider Name (Legal Business Name): LIFE WORTH LIVING FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2008
Last Update Date: 09/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1507 PARK CENTER DR SUITE 1L
ORLANDO FL
32835-5795
US

IV. Provider business mailing address

1507 PARK CENTER DR SUITE 1L
ORLANDO FL
32835-5795
US

V. Phone/Fax

Practice location:
  • Phone: 407-522-4154
  • Fax:
Mailing address:
  • Phone: 407-522-4154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH AYOTUNDE
Title or Position: OWNER
Credential:
Phone: 407-522-4154