Healthcare Provider Details

I. General information

NPI: 1386589349
Provider Name (Legal Business Name): BALANCED WELLBEING NATIONWIDE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 INTERSTATE CORPORATE CTR STE 300
WILLISTON VT
05495-7821
US

IV. Provider business mailing address

3932 W EAU GALLIE BLVD
MELBOURNE FL
32934-3283
US

V. Phone/Fax

Practice location:
  • Phone: 877-779-2429
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PARIKSHIT DESHMUKH
Title or Position: CEO
Credential: MD
Phone: 352-445-1200