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General NPI Number Information
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NPI Number | 1487148706
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Entity Type | Organization
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Legal Business Name | PERFECT BALANCE HEALTHCARE, PLLC
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Dates
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Enumeration Date | 06/20/2018
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Last Update Date | 06/20/2018
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Provider Practice Location Address
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Address Line | 7500 LIVE OAK DR.
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City | CORAL SPRINGS
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State | FL
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Zip | 33065
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Country | US
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Telephone | 855-724-8786
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Fax | 855-724-8786
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Provider Business Mailing Address
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Address Line | 1293 N. UNIVERSITY DR. # 153
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City | CORAL SPRINGS
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State | FL
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Zip | 33071
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Country | US
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Telephone | 855-724-8786
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Fax | 855-724-8786
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Authorized Official
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Title or Position | PHARMACIST
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Name | MS. NANDITA SARAH KOODIE
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Credential | PHARM. D.
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Telephone | 855-724-8786
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS52571
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License Number State | FL
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