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General NPI Number Information
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NPI Number | 1164281838
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Entity Type | Organization
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Legal Business Name | FLORIDA YOGA ACADEMY, LLC
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Dates
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Enumeration Date | 03/15/2024
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 3916 ORANGE GROVE BLVD APT 5
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-4961
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Country | US
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Telephone | 239-265-4367
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Fax |
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Provider Business Mailing Address
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Address Line | 3916 ORANGE GROVE BLVD APT 5
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-4961
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Country | US
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Telephone | 239-265-4367
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | INGA BALCIUNIENE
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Credential |
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Telephone | 239-265-4367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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