Provider Demographics
NPI:1952756868
Name:ESTATES BALANCE CENTER LLC
Entity Type:Organization
Organization Name:ESTATES BALANCE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ZARRANZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-349-2500
Mailing Address - Street 1:11725 COLLIER BLVD
Mailing Address - Street 2:SUITE H1
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34116-6524
Mailing Address - Country:US
Mailing Address - Phone:239-349-2500
Mailing Address - Fax:239-349-2501
Practice Address - Street 1:1525 SW 52ND TER
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33914-7485
Practice Address - Country:US
Practice Address - Phone:239-349-2500
Practice Address - Fax:239-349-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-28
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME6001261QM2500X
302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance Organization