Healthcare Provider Details

I. General information

NPI: 1508207648
Provider Name (Legal Business Name): BEING HEALTHY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2013
Last Update Date: 02/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 W GUAVA ST SUITE 206
LADY LAKE FL
32159-1701
US

IV. Provider business mailing address

201 W GUAVA ST SUITE 206
LADY LAKE FL
32159-1701
US

V. Phone/Fax

Practice location:
  • Phone: 352-205-9897
  • Fax: 888-426-0410
Mailing address:
  • Phone: 352-205-9897
  • Fax: 888-426-0410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number125278
License Number StateFL

VIII. Authorized Official

Name: UTKARSH S PATEL
Title or Position: CO-OWNER & OPERATOR
Credential: PT
Phone: 352-205-9897