Provider Demographics
NPI:1346407517
Name:THE BANYAN INSTITUTES, LLC
Entity Type:Organization
Organization Name:THE BANYAN INSTITUTES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-898-6020
Mailing Address - Street 1:6619 S DIXIE HWY
Mailing Address - Street 2:SUITE 229
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-7919
Mailing Address - Country:US
Mailing Address - Phone:305-663-5696
Mailing Address - Fax:305-663-5699
Practice Address - Street 1:8603 S DIXIE HWY
Practice Address - Street 2:SUITE 217
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-7807
Practice Address - Country:US
Practice Address - Phone:305-663-5696
Practice Address - Fax:305-663-5699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP1369171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty