Provider Demographics
NPI:1558460683
Name:SEBRING HEALTH & WELLNESS CENTER INC
Entity Type:Organization
Organization Name:SEBRING HEALTH & WELLNESS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:L KIRSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEADS
Authorized Official - Suffix:
Authorized Official - Credentials:DOM, AP
Authorized Official - Phone:863-314-9800
Mailing Address - Street 1:PO BOX 7604
Mailing Address - Street 2:2190 LAKEVIEW DRIVE
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33872-0111
Mailing Address - Country:US
Mailing Address - Phone:863-314-9800
Mailing Address - Fax:863-582-9900
Practice Address - Street 1:2190 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-4967
Practice Address - Country:US
Practice Address - Phone:863-314-9800
Practice Address - Fax:863-582-9900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL643642-0024587111N00000X, 171100000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Not Answered171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9610Medicare ID - Type Unspecified