NPIMap

Organization Active NPI

Professional Healing Services LLC

  • Clinic/Center
  • Lakeland, FL
National Provider Identifier
1235452459
Registry record updated Mar 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
HCC7925 Issued in FL
Legal business name
PROFESSIONAL HEALING SERVICES LLC
Practice address
5130 S Florida Ave
Suite 410
Lakeland, FL 33813-2537
Phone
(863) 937-8814
Fax
(863) 937-8815
NPI assigned
Mar 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Roberto Li Sr., LMT
Title
Owner
Phone
(863) 937-8814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X HCC7925 FL Primary

Addresses

Primary practice location

5130 S Florida Ave
Suite 410
Lakeland, FL 33813-2537

Mailing address

5130 S Florida Ave
Suite 410
Lakeland, FL 33813-2537
Phone (863) 937-8814

National Provider Directory

National Provider Directory

Locations

5130 S Florida Ave
Ste 410
Lakeland, FL 33813
Phone (863) 937-8814

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267488000000",
    "number": "1235452459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5130 S FLORIDA AVE",
            "address_2": "SUITE 410",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132537",
            "telephone_number": "863-937-8814",
            "fax_number": "863-937-8815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5130 S FLORIDA AVE",
            "address_2": "SUITE 410",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132537",
            "telephone_number": "863-937-8814",
            "fax_number": "863-937-8815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL HEALING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-02",
        "last_updated": "2010-03-02",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "ROBERTO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-937-8814",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "HCC7925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.