Provider Demographics
NPI:1295260974
Name:HEALING SOLUTION CENTER L
Entity type:Organization
Organization Name:HEALING SOLUTION CENTER L
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:PICILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-234-2469
Mailing Address - Street 1:1380 NE MIAMI GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33179-4707
Mailing Address - Country:US
Mailing Address - Phone:954-234-2469
Mailing Address - Fax:954-204-0464
Practice Address - Street 1:1380 NE MIAMI GARDENS DR
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33179-4707
Practice Address - Country:US
Practice Address - Phone:954-234-2469
Practice Address - Fax:954-204-0464
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALING SOLUTION CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10D2128247291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL10D2128247OtherCLIA LABORATORY