Healthcare Provider Details

I. General information

NPI: 1144105867
Provider Name (Legal Business Name): HORMONA VIDA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 PGA BLVD STE 600
PALM BEACH GARDENS FL
33410-2756
US

IV. Provider business mailing address

3801 PGA BLVD STE 600
PALM BEACH GARDENS FL
33410-2756
US

V. Phone/Fax

Practice location:
  • Phone: 888-855-8434
  • Fax: 888-855-2041
Mailing address:
  • Phone: 888-855-8434
  • Fax: 888-855-2041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KAREN BERRIOS
Title or Position: FOUNDER AND CEO
Credential:
Phone: 888-855-8434