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VITALIFE MED LLC
NPI 1730017674
Nurse Practitioner - Family in Fort Myers, FL

Active since May 11, 2026CLIA 10D2345829 · Waiver
2540 WINKLER AVE STE 1, FORT MYERS, FL 33901(239) 347-0810(754) 229-5558 Get Directions Write a Review

NPPES record last updated: June 3, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jun 3, 2026, May 11, 2026 (2 updates tracked since 2026).

About Vitalife Med Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VITALIFE MED LLC (NPI 1730017674) is a healthcare organization registered as a family in Fort Myers, Florida and active in the NPI registry since May 2026. The organization holds a CLIA Waiver certificate valid through June 17, 2028 and lists Lianet E Coello Blanco, President, as its authorized official.

NPPES Registry Identity

NPI1730017674
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameVITALIFE MED LLC
Location Address2540 WINKLER AVE STE 1Fort Myers, FL 33901-9338
Mailing Address2540 Winkler Ave Ste 1Fort Myers, FL 33901-9338 · (239) 347-0810 · Fax (754) 229-5558
Phone(239) 347-0810
Fax(754) 229-5558
Organization SubpartNo
Authorized OfficialLianet E Coello BlancoPresident · (239) 347-0810
Enumeration DateMay 11, 2026
Last NPPES UpdateJune 3, 20262 updates tracked since enumeration
NPPES CertifiedJune 3, 2026
✔ NPI 1730017674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
Also ListedClinic/CenterTaxonomy 261Q00000X
Also ListedNurse PractitionerTaxonomy 363L00000X
2540 WINKLER AVE STE 1, Fort Myers, FL 33901
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vitalife Med Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Vitalife Med LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Lianet Coello Blanco, APRN
Nurse Practitioner
NPI 1033748041
2540 WINKLER AVE # 1
Fort Myers, FL 33901
(239) 347-0810
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2345829

Vitalife Med LLC · Fort Myers, FL
Active · expires Jun 17, 2028
CLIA Number10D2345829
Laboratory TypePhysician Office
Certificate Effective DateJune 18, 2026
Certificate Expiration DateJune 17, 2028
Laboratory DirectorLianet E. Coello Blanco
Laboratory Phone(239) 347-0810
Laboratory LocationVitalife Med LLC2540 Winkler Avenue, Suite 1, Fort Myers, FL 33901
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vitalife Med LLC's NPI number?

The NPI number for Vitalife Med LLC is 1730017674. It was assigned to this organization in the NPPES registry on May 11, 2026.

Where is Vitalife Med LLC located?

Vitalife Med LLC is located at 2540 Winkler Ave Ste 1, Fort Myers, FL 33901. The listed phone number is (239) 347-0810.

What is Vitalife Med LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Vitalife Med LLC enrolled in Medicare?

Yes. Vitalife Med LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Vitalife Med LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Vitalife Med LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Vitalife Med LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2345829) is associated with this NPI, valid through June 17, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vitalife Med LLC was last updated on June 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.