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General NPI Number Information
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NPI Number | 1114753761
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Entity Type | Organization
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Legal Business Name | INNER BALANCE HEALTH CENTER LLC
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 13190 SW 134TH ST STE 106
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City | MIAMI
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State | FL
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Zip | 33186-4496
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Country | US
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Telephone | 786-209-0023
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Fax |
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Provider Business Mailing Address
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Address Line | 11125 SW 243RD ST
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City | HOMESTEAD
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State | FL
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Zip | 33032-5148
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Country | US
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Telephone | 786-209-0023
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAURA DIAZ
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Credential | R.N.
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Telephone | 786-222-9194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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