Provider Demographics
NPI:1902828650
Name:HIGHLANDS HEALTH AND WELLNESS CENTER LLC
Entity Type:Organization
Organization Name:HIGHLANDS HEALTH AND WELLNESS CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOUSSAINT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-382-0009
Mailing Address - Street 1:1739 US HIGHWAY 27 S
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-4920
Mailing Address - Country:US
Mailing Address - Phone:863-382-0009
Mailing Address - Fax:863-314-0008
Practice Address - Street 1:1739 US HIGHWAY 27 S
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-4920
Practice Address - Country:US
Practice Address - Phone:863-382-0009
Practice Address - Fax:863-314-0008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-24
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME57175207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDF3464OtherRAILROAD MEDICARE
FLQ0520Medicare PIN
FLE60452Medicare UPIN