Healthcare Provider Details

I. General information

NPI: 1598898850
Provider Name (Legal Business Name): HEALTHY LYMPHATICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 SE OSCEOLA ST
STUART FL
34994-2322
US

IV. Provider business mailing address

479 NW PRIMA VISTA BLVD
PORT ST LUCIE FL
34983-8731
US

V. Phone/Fax

Practice location:
  • Phone: 772-408-4848
  • Fax: 772-408-0978
Mailing address:
  • Phone: 772-408-4848
  • Fax: 772-408-0978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License NumberOT8297
License Number StateFL

VIII. Authorized Official

Name: MS. CARMEN MARIA ALBU
Title or Position: OWNER
Credential: MOTR
Phone: 772-408-4848