Provider Demographics
NPI:1003842667
Name:THE HUMAN BALANCE CENTER
Entity Type:Organization
Organization Name:THE HUMAN BALANCE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARQUIMEDES
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:772-581-8378
Mailing Address - Street 1:12920 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3772
Mailing Address - Country:US
Mailing Address - Phone:772-581-5837
Mailing Address - Fax:772-539-9254
Practice Address - Street 1:12920 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3772
Practice Address - Country:US
Practice Address - Phone:772-581-5837
Practice Address - Fax:772-539-9254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL4629261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU3863Medicare ID - Type UnspecifiedIDTF