MEDICARE: ELEVATE HEALTH 360 LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner

General Provider Information

NPI Number	:	1427984939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELEVATE HEALTH 360 LLC

Provider Business Mailing Address
First Line	:	13441 SW 17TH CT
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-3447
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13441 SW 17TH CT
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33027-3447
Country	:	US
Telephone Number	:	754-301-0615
Fax Number	:

Authorized Official
Title or Position	:	OWNER AND MANAGING MEMBER
Name	:	FARIDA VILDANOVA
Credential	:	FNP-BC
Telephone Number	:	754-301-0615

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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Directions to “ELEVATE HEALTH 360 LLC ” Practice Location

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