Healthcare Provider Details

I. General information

NPI: 1841097391
Provider Name (Legal Business Name): HEALTHY LYMPHATICS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 03/03/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 BUFORD BLVD STE A
TALLAHASSEE FL
32308-4668
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 TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: TONI SALTMARSH
Title or Position: OFFICE MANAGER
Credential:
Phone: 772-204-3792