Provider Demographics
NPI:1922472000
Name:VIBRANCE WELLNESS LLC
Entity Type:Organization
Organization Name:VIBRANCE WELLNESS LLC
Other - Org Name:HEALING ALTERNATIVES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MNGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MENDOZA
Authorized Official - Last Name:BEAURY
Authorized Official - Suffix:
Authorized Official - Credentials:DOM / AP
Authorized Official - Phone:407-682-7111
Mailing Address - Street 1:460 W CENTRAL PKWY
Mailing Address - Street 2:
Mailing Address - City:ALTAMONTE SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32714-2415
Mailing Address - Country:US
Mailing Address - Phone:407-682-7111
Mailing Address - Fax:407-682-7180
Practice Address - Street 1:460 W CENTRAL PKWY
Practice Address - Street 2:
Practice Address - City:ALTAMONTE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32714-2415
Practice Address - Country:US
Practice Address - Phone:407-682-7111
Practice Address - Fax:407-682-7180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-30
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAP3676171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty