Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

The Center for Functional Aesthetic and Anti Aging Medicine Inc

Organization Naturopath · NPI 1508682089

The Center for Functional Aesthetic and Anti Aging Medicine Inc is a Naturopath in Winter Haven, Florida. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

571 Avenue K SE
Winter Haven, FL 33880-4215
Phone: (407) 440-0708
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X
Naturopath Taxonomy 175F00000X
Obesity Medicine (Preventive Medicine) Physician Taxonomy 2083B0002X

Record details

NPI number1508682089
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Danice Blaise — Chief Executive Officer, Owner · (954) 681-0068
NPI enumeratedNovember 29, 2024
Last updated in NPPESNovember 29, 2024
Certification dateNovember 28, 2024
Mailing address571 Avenue K Se, Winter Haven, FL 33880-4215