Provider Demographics
NPI:1598898850
Name:HEALTHY LYMPHATICS INC
Entity Type:Organization
Organization Name:HEALTHY LYMPHATICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ALBU
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR
Authorized Official - Phone:772-408-4848
Mailing Address - Street 1:479 NW PRIMA VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983-8731
Mailing Address - Country:US
Mailing Address - Phone:772-408-4848
Mailing Address - Fax:772-408-0978
Practice Address - Street 1:518 SE OSCEOLA ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2322
Practice Address - Country:US
Practice Address - Phone:772-408-4848
Practice Address - Fax:772-408-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT8297261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation