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General NPI Number Information
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NPI Number | 1811832850
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Entity Type | Organization
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Legal Business Name | CORE LIFE LINK INC
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Dates
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Enumeration Date | 04/23/2026
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Last Update Date | 04/23/2026
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Provider Practice Location Address
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Address Line | 1435 DUNN AVE STE 102
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1434
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Country | US
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Telephone | 386-449-9760
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Fax |
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Provider Business Mailing Address
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Address Line | 1435 DUNN AVE STE 102
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-1434
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FOUNDER/CEO
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Name | MHAI NANG AGRABA
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Credential | PHARMD
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Telephone | 386-449-9760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP0905X
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Taxonomy Name | State or Local Public Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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