Healthcare Provider Details

I. General information

NPI: 1093962425
Provider Name (Legal Business Name): MEDICAL HEALING ARTS CENTER OF STUART LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SE OSCEOLA ST SUITE 102
STUART FL
34994-2149
US

IV. Provider business mailing address

55 SE OSCEOLA ST SUITE 102
STUART FL
34994-2149
US

V. Phone/Fax

Practice location:
  • Phone: 772-634-0730
  • Fax:
Mailing address:
  • Phone: 772-634-0730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JAMES N GEORGIADES
Title or Position: OWNER
Credential: AP
Phone: 772-634-0730