MEDICARE: LIUVIT ALDAMA GAROFALO 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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1801767785
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIUVIT ALDAMA GAROFALO LLC.

Provider Business Mailing Address
First Line	:	7901 4TH ST N # 9258
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4305
Country	:	US
Telephone Number	:	407-663-1745
Fax Number	:	407-214-8693

Provider Business Practice Location Address
First Line	:	3891 CARRICK BEND DR
Second Line	:
City	:	KISSIMMEE
State	:	FL
Zip	:	34746-2975
Country	:	US
Telephone Number	:	407-663-1745
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUTHORIZED OFFICIAL
Name	:	LIUVIT ALDAMA GAROFALO
Credential	:
Telephone Number	:	407-663-1745

Provider Enumeration Date	:	09/15/2025
Last Update Date	:	04/08/2026

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