THE CENTER FOR FUNCTIONAL AESTHETIC AND ANTI AGING MEDICINE INC
NPI 1508682089
Internal Medicine in Winter Haven, FL

Active since November 29, 2024
571 AVENUE K SE, WINTER HAVEN, FL 33880(407) 440-0708 Get Directions Write a Review

NPPES record last updated: November 29, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Internal Medicine

About THE CENTER FOR FUNCTIONAL AESTHETIC AND ANTI AGING MEDICINE INC

This page provides the complete NPI Profile along with additional information for The Center For Functional Aesthetic And Anti Aging Medicine Inc, an internist established in Winter Haven, Florida operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1508682089 assigned on November 2024. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The Center For Functional Aesthetic And Anti Aging Medicine Inc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Danice Blaise Md, Mba (Chief Executive Officer, Owner)

NPI
1508682089 Verify this NPI
Provider Name
THE CENTER FOR FUNCTIONAL AESTHETIC AND ANTI AGING MEDICINE INC
Entity Type
Organization
Location Address
571 AVENUE K SE WINTER HAVEN, FL 33880
Location Phone
(407) 440-0708
Mailing Address
571 AVENUE K SE WINTER HAVEN, FL 33880
Mailing Phone
(407) 440-0708
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-29-2024
Last Update Date
11-29-2024
Code Navigator

An internist like The Center For Functional Aesthetic And Anti Aging Medicine Inc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1175F00000XOther Service Providers

Naturopath

 
22083B0002XAllopathic & Osteopathic Physicians

Preventive Medicine
Obesity Medicine

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. DANICE BLAISE MD, MBA

Authorized Official Title
CHIEF EXECUTIVE OFFICER, OWNER
Authorized Official Phone
(954) 681-0068

Reviews for THE CENTER FOR FUNCTIONAL AESTHETIC AND ANTI AGING MEDICINE INC

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Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Psychiatry & Neurology (Psychiatry)
571 AVENUE K SE
WINTER HAVEN, FL 33880
Specialist
571 AVENUE K SE
WINTER HAVEN, FL 33880

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1508682089, enumerated as an "organization" on November 29, 2024.

The provider is located at 571 AVENUE K SE WINTER HAVEN, FL 33880 and the phone number is (407) 440-0708.

Internal Medicine with taxonomy code 207R00000X.