| Managed Healthy Living Inc | |
|
4804 Edgewater Dr Ste A Orlando FL 32804-1126 | |
| (407) 574-3030 | |
| (321) 697-7000 |
| Full Name | Managed Healthy Living Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4804 Edgewater Dr Ste A, Orlando, Florida |
| Authorized Official Name and Position | Marlene Vernonia Lindsay (ADMINISTRATOR) |
| Authorized Official Contact | 4075743030 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Managed Healthy Living Inc 4804 Edgewater Dr Ste A Orlando FL 32804-1126 Ph: (407) 574-3030 | Managed Healthy Living Inc 4804 Edgewater Dr Ste A Orlando FL 32804-1126 Ph: (407) 574-3030 |
| NPI Number | 1104595735 |
|---|---|
| Provider Enumeration Date | 09/08/2021 |
| Last Update Date | 09/16/2021 |
| Medicare PECOS PAC ID | 1355739558 |
|---|---|
| Medicare Enrollment ID | O20211020001651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104595735 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Marlene V Lindsay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336163823 PECOS PAC ID: 5799709721 Enrollment ID: I20060118000148 |
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