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NPI Code Detail

MEDICARE: LIFESTYLE HEALING INSTITUTE LLC

MEDICARE: LIFESTYLE HEALING INSTITUTE 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
1208200000XPlastic Surgery Physician
2208D00000XGeneral Practice Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598350613
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFESTYLE HEALING INSTITUTE LLC
Provider Business Mailing Address
First Line : 1715 HERITAGE TRL STE 203
Second Line :
City : NAPLES
State : FL
Zip : 34112-8715
Country : US
Telephone Number : 866-663-3869
Fax Number :
Provider Business Practice Location Address
First Line : 1715 HERITAGE TRL STE 203
Second Line :
City : NAPLES
State : FL
Zip : 34112-8715
Country : US
Telephone Number : 866-663-3869
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICIAL
Name : WILLIAM MURTAGH
Credential : MD
Telephone Number : 866-663-3869
Provider Enumeration Date : 03/02/2021
Last Update Date : 04/29/2021

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Directions to “LIFESTYLE HEALING INSTITUTE LLC ” Practice Location

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