Provider Demographics
NPI:1396052627
Name:HEALTHY LYMPHATICS, INC
Entity type:Organization
Organization Name:HEALTHY LYMPHATICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:ALBU
Authorized Official - Suffix:
Authorized Official - Credentials:MOTR/L, CLT-LANA, WC
Authorized Official - Phone:828-964-3026
Mailing Address - Street 1:479 NW PRIMA VISTA BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:PORT ST. LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34983
Mailing Address - Country:US
Mailing Address - Phone:772-408-4848
Mailing Address - Fax:772-408-0978
Practice Address - Street 1:479 NW PRIMA VISTA BOULEVARD
Practice Address - Street 2:
Practice Address - City:PORT ST. LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34983
Practice Address - Country:US
Practice Address - Phone:772-408-4848
Practice Address - Fax:772-408-0978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-08
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT7000225X00000X
FLOT8297225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty