| NPI | 1255182747 |
|---|---|
| Former Legal Business Name | BALANCE LIFE HEALTHCARE LLC |
| Entity Type | Organization |
| Authorized Contact | LOURDES BENITEZ Manager 239-703-4182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |