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General NPI Number Information
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NPI Number | 1497553077
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Entity Type | Organization
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Legal Business Name | LEHEAL BIOGENIX HQ LLC
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Dates
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Enumeration Date | 03/07/2025
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Last Update Date | 03/07/2025
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Provider Practice Location Address
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Address Line | 2007 W SWANN AVE
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City | TAMPA
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State | FL
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Zip | 33606-2483
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Country | US
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Telephone | 813-505-6921
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Fax |
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Provider Business Mailing Address
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Address Line | 8310 REVELS RD
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City | RIVERVIEW
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State | FL
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Zip | 33569-4724
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Country | US
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Telephone | 813-505-6921
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | STACEY HEALD
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Credential |
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Telephone | 813-505-6921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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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 | 261QP3300X
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Taxonomy Name | Pain 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 | 2083S0010X
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Taxonomy Name | Sports Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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