Provider Demographics
NPI:1184209991
Name:TOTAL LIFE HEALTH CENTER LLLP
Entity Type:Organization
Organization Name:TOTAL LIFE HEALTH CENTER LLLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARLING
Authorized Official - Middle Name:
Authorized Official - Last Name:ST JEAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:863-812-4334
Mailing Address - Street 1:215 ORANGE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-3447
Mailing Address - Country:US
Mailing Address - Phone:863-812-4334
Mailing Address - Fax:863-662-3232
Practice Address - Street 1:215 ORANGE ST STE 3
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-3447
Practice Address - Country:US
Practice Address - Phone:863-812-4334
Practice Address - Fax:863-662-3232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty