LIFE BALANCE MEDICAL GROUP LLC (NPI# 1336775733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336775733 |
| Entity Type | Organization |
| Organization Name | LIFE BALANCE MEDICAL GROUP LLC |
| Practice Address |
4102 W Linebaugh Ave Ste 101 Tampa FL 33624-5296 |
| Practice Telephone | 8138674910 |
| Practice Fax Number | 8134438221 |
| Mailing Telephone | 8138674910 |
| Mailing Fax Number | 8134438221 |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-03-17 |
| Authorized Official Name | PEDRO M HERNANDEZ (OWNER) |
| Authorized Official Telephone | 8138674910 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
4102 W LINEBAUGH AVE STE 101 |
| City | TAMPA |
| State | FL |
| Zip Code | 33624-5296 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922617380 | Transforming Treasures LLC | Behavioral Analyst | 4810 Centerbrook Ct, Tampa, FL 33624 | 2020-07-30 |
| 1467097642 | Sherryl Lynn Johnson-hanna | Dietitian, Registered | 4904 Rambling Rose Place, Tampa, FL 33624 | 2019-11-12 |
| 1679125926 | Nurse Practitioner On The Go | In Home Supportive Care | 16411 Oak Manor Drive, Tampa, FL 33624 | 2019-07-16 |
| 1427547587 | Sylicia Marks | Counselor | 4105 Brentwood Park Cir, Tampa, FL 33624 | 2018-05-04 |
| 1407352917 | Shelley Von Hightower | Pharmacist | 5008 W. Linebaugh Ave, Suite 35, Tampa, FL 33624 | 2018-04-03 |
| 1972002178 | Zachary Winterberg | Specialist/Technologist | 3821 Northgreen Ave Apt 1407, Tampa, FL 33624 | 2018-02-03 |
| 1013423268 | Beyond Care Home Health LLC | Home Health | 3903 Northdale Bvld, 100e, Tampa, FL 33624 | 2017-12-26 |
| 1285148841 | Gary Donald Kociszewski Jr. | Behavior Technician | 4920 Traskwood Ct, Tampa, FL 33624 | 2017-11-18 |
| 1932611944 | Valerie Lauren Martinez | Behavior Technician | 14039 Wolcott Dr, Tampa, FL 33624 | 2017-10-31 |
| 1073038287 | Mesfin T Araya | Non-emergency Medical Transport (VAN) | 4403 Akita Dr, Tampa, FL 33624 | 2017-08-09 |
| Find all providers in zip 33624 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1508324781 | Breakthrough Counseling Services, LLC | Clinic/Center | 3105 W Azeele St, Tampa, FL 33609-3089 | 2019-03-07 |
| 1013405281 | Crudup Psychological Services LLC | Clinic/Center | 10001 Cross Creek Blvd, Tampa, FL 33647-2581 | 2018-04-24 |
| 1346753134 | Mental Fitness Group, LLC | Clinic/Center | 8875 Hidden River Pkwy Ste 300, Tampa, FL 33637 | 2017-11-15 |
| 1427567353 | Stephen Kane Lmhc Pa | Clinic/Center | 10347 Cross Creek Blvd Ste B, Tampa, FL 33647-2993 | 2017-09-22 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.