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NPI Code Detail

MEDICARE: HEALTHLINE BALANCE CENTER INC

MEDICARE: HEALTHLINE BALANCE CENTER INC
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
1261Q00000XClinic/CenterHCC6239FL

General Provider Information

NPI Number : 1588615348
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEALTHLINE BALANCE CENTER INC
Provider Business Mailing Address
First Line : 951 NE 167TH ST
Second Line : SUITE 114
City : NORTH MIAMI BEACH
State : FL
Zip : 33162-3711
Country : US
Telephone Number : 305-653-2021
Fax Number : 954-474-7605
Provider Business Practice Location Address
First Line : 951 NE 167TH ST
Second Line : SUITE 114
City : NORTH MIAMI BEACH
State : FL
Zip : 33162-3711
Country : US
Telephone Number : 305-653-2021
Fax Number : 954-474-7605
Authorized Official
Title or Position : PRESIDENT OWNER
Name : MR. FELIX BOGOMOLNY
Credential :
Telephone Number : 305-653-2021
Provider Enumeration Date : 05/15/2006
Last Update Date : 08/22/2020

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