| Life Balance Medical Group Llc | |
|
2916 W Waters Ave Ste A1 Tampa FL 33614-1869 | |
| (813) 443-8221 | |
| (813) 443-1869 |
| Full Name | Life Balance Medical Group Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 2916 W Waters Ave Ste A1, Tampa, Florida |
| Authorized Official Name and Position | Pedro M Hernandez (OWNER) |
| Authorized Official Contact | 8134438221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Balance Medical Group Llc Po Box 151686 Tampa FL 33684-1686 Ph: (813) 443-8221 | Life Balance Medical Group Llc 2916 W Waters Ave Ste A1 Tampa FL 33614-1869 Ph: (813) 443-8221 |
| NPI Number | 1336775733 |
|---|---|
| Provider Enumeration Date | 03/17/2020 |
| Last Update Date | 09/21/2021 |
| Certification Date | 09/21/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336775733 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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