Provider Demographics
NPI:1437560026
Name:GOOD LIVING HABITS, LLC
Entity Type:Organization
Organization Name:GOOD LIVING HABITS, LLC
Other - Org Name:ACTIFY PHYSIOTHERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:CRISTIANE
Authorized Official - Last Name:MEDINA
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:561-366-2435
Mailing Address - Street 1:7419 AVENIDA DEL MAR
Mailing Address - Street 2:#2706
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-4872
Mailing Address - Country:US
Mailing Address - Phone:561-366-2435
Mailing Address - Fax:561-366-2535
Practice Address - Street 1:7000 W PALMETTO PARK RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3424
Practice Address - Country:US
Practice Address - Phone:561-366-2435
Practice Address - Fax:561-366-2535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty