Healthcare Provider Details

I. General information

NPI: 1578489514
Provider Name (Legal Business Name): ONELIFE MEDICAL & WELLNESS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5788 SW 8TH ST
WEST MIAMI FL
33144-5034
US

IV. Provider business mailing address

5788 SW 8TH ST
WEST MIAMI FL
33144-5034
US

V. Phone/Fax

Practice location:
  • Phone: 786-503-5372
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MANUEL ANTONIO MORALES BORGES
Title or Position: OWNER
Credential:
Phone: 786-503-5372