MEDICARE: HEALING INFINITELY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225100000X	Physical Therapist
3	225X00000X	Occupational Therapist
4	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1366164279
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALING INFINITELY, LLC

Provider Business Mailing Address
First Line	:	610 E ZACK ST STE 110-3005
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3972
Country	:	US
Telephone Number	:	727-807-9713
Fax Number	:	727-933-0983

Provider Business Practice Location Address
First Line	:	610 E ZACK ST STE 110-3005
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-3972
Country	:	US
Telephone Number	:	727-807-9713
Fax Number	:	727-933-0983

Authorized Official
Title or Position	:	CEO
Name	:	SHLABERTE SAINTLOUIS
Credential	:
Telephone Number	:	786-348-7387

Provider Enumeration Date	:	09/16/2022
Last Update Date	:	10/04/2022

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