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General NPI Number Information
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NPI Number | 1861276156
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Entity Type | Organization
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Legal Business Name | BELLA VIDA WELLNESS SERVICES INC
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Dates
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Enumeration Date | 08/21/2023
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 4483 NW 36TH ST STE 112
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-7260
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Country | US
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Telephone | 305-392-0106
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Fax |
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Provider Business Mailing Address
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Address Line | 4483 NW 36TH ST STE 112
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City | MIAMI SPRINGS
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State | FL
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Zip | 33166-7260
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Country | US
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Telephone | 305-392-0106
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Fax |
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Authorized Official
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Title or Position | AUTONOMOUS NURSE PRACTITIONER
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Name | LEONIDA HERNANDEZ SOTO
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Credential | NP
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Telephone | 786-286-7041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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