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General NPI Number Information
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NPI Number | 1427356617
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Entity Type | Organization
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Legal Business Name | ABSOLUTE BALANCE OF LIFE HEALTH AND WELLNESS CENTER, INC.
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 101 PLAZA REAL S SUITE G.
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City | BOCA RATON
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State | FL
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Zip | 33432-4837
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Country | US
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Telephone | 561-353-2265
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Fax | 561-353-2267
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Provider Business Mailing Address
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Address Line | 2561 NW 79TH AVE
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City | MARGATE
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State | FL
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Zip | 33063-8156
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Country | US
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Telephone | 561-353-2265
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Fax | 561-353-2267
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. BRAZELIA LAZZARI
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Credential | D.O.M., A.P.
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Telephone | 561-353-2265
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AP2366
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME36889
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License Number State | FL
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