Balanced Life Therapy Center, Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA26724 Issued in FL

Legal business name

BALANCED LIFE THERAPY CENTER, INC

Practice address

1913 W Sligh Ave
Tampa, FL 33604-5813

Phone

(813) 374-9052

Fax

(813) 374-9053

NPI assigned

Feb 28, 2009

Organization subpart

No

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

Authorized official

Name

Anastasia L Maldonado, LMT

Title

President

Phone

(813) 374-9052

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1235779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235779200000",
    "number": "1366682510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1913 W SLIGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336045813",
            "telephone_number": "813-374-9052",
            "fax_number": "813-374-9053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1913 W SLIGH AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336045813",
            "telephone_number": "813-374-9052",
            "fax_number": "813-374-9053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIFE THERAPY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-28",
        "last_updated": "2009-02-28",
        "status": "A",
        "authorized_official_last_name": "MALDONADO",
        "authorized_official_first_name": "ANASTASIA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-374-9052",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA26724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Tampa, FL
• Providers in Tampa, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2009; 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.