Provider Demographics
NPI:1336788603
Name:HEALTHSTYLE THERAPEUTIX, LLC
Entity Type:Organization
Organization Name:HEALTHSTYLE THERAPEUTIX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-698-3509
Mailing Address - Street 1:7061 GRAND NATIONAL DR STE 107A
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8962
Mailing Address - Country:US
Mailing Address - Phone:800-279-9368
Mailing Address - Fax:407-442-3420
Practice Address - Street 1:7061 GRAND NATIONAL DR STE 107A
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8962
Practice Address - Country:US
Practice Address - Phone:800-279-9368
Practice Address - Fax:407-442-3420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies