Inner Balance Family Medicine, Llc | |
1880 Se Port Saint Lucie Blvd Port Saint Lucie FL 34952-5545 | |
(772) 249-0636 | |
(772) 237-3114 |
Full Name | Inner Balance Family Medicine, Llc |
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Speciality | Family Medicine |
Location | 1880 Se Port Saint Lucie Blvd, Port Saint Lucie, Florida |
Authorized Official Name and Position | Dionne Layne Hinds (OWNER) |
Authorized Official Contact | 7722490636 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inner Balance Family Medicine, Llc 1880 Se Port Saint Lucie Blvd Port Saint Lucie FL 34952-5545 Ph: (772) 249-0636 | Inner Balance Family Medicine, Llc 1880 Se Port Saint Lucie Blvd Port Saint Lucie FL 34952-5545 Ph: (772) 249-0636 |
NPI Number | 1851729693 |
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Provider Enumeration Date | 10/14/2013 |
Last Update Date | 06/07/2018 |
Medicare PECOS PAC ID | 6305072455 |
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Medicare Enrollment ID | O20131119000750 |
Identifier | Type | State | Issuer |
---|---|---|---|
1851729693 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | ME106391 (Florida) | Primary |
Provider Name | Dionne L Hinds |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1154593184 PECOS PAC ID: 8820123060 Enrollment ID: I20100312000982 |
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