Provider Demographics
NPI:1093962425
Name:MEDICAL HEALING ARTS CENTER OF STUART LLC
Entity Type:Organization
Organization Name:MEDICAL HEALING ARTS CENTER OF STUART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:N
Authorized Official - Last Name:GEORGIADES
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:772-634-0730
Mailing Address - Street 1:55 SE OSCEOLA ST
Mailing Address - Street 2:SUITE 102
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2149
Mailing Address - Country:US
Mailing Address - Phone:772-634-0730
Mailing Address - Fax:
Practice Address - Street 1:55 SE OSCEOLA ST
Practice Address - Street 2:SUITE 102
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2149
Practice Address - Country:US
Practice Address - Phone:772-634-0730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-27
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty