Healthcare Provider Details

I. General information

NPI: 1083549919
Provider Name (Legal Business Name): CORVANTA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4240 COLLIN DR
WEST PALM BEACH FL
33406-4827
US

IV. Provider business mailing address

4240 COLLIN DR
WEST PALM BEACH FL
33406-4827
US

V. Phone/Fax

Practice location:
  • Phone: 786-955-4891
  • Fax:
Mailing address:
  • Phone: 786-955-4891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State

VIII. Authorized Official

Name: SASHA GUTIERREZ
Title or Position: MANAGER
Credential:
Phone: 786-955-4891