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General NPI Number Information
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NPI Number | 1437560026
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Entity Type | Organization
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Legal Business Name | GOOD LIVING HABITS, LLC
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 05/16/2014
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Provider Practice Location Address
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Address Line | 7000 W PALMETTO PARK RD SUITE 210
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City | BOCA RATON
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State | FL
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Zip | 33433-3424
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Country | US
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Telephone | 561-366-2435
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Fax | 561-366-2535
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Provider Business Mailing Address
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Address Line | 7419 AVENIDA DEL MAR #2706
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City | BOCA RATON
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State | FL
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Zip | 33433-4872
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Country | US
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Telephone | 561-366-2435
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Fax | 561-366-2535
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MARCIA CRISTIANE MEDINA
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Credential | PT, DPT
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Telephone | 561-366-2435
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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