Provider Demographics
NPI:1801597521
Name:HEALING LOVE CENTER LLC
Entity type:Organization
Organization Name:HEALING LOVE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BIENVENIDO
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEVES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-764-7679
Mailing Address - Street 1:14 WOOD RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34482-6678
Mailing Address - Country:US
Mailing Address - Phone:407-764-7679
Mailing Address - Fax:
Practice Address - Street 1:14 WOOD RIDGE DR
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34482-6678
Practice Address - Country:US
Practice Address - Phone:407-764-7679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical GeneticsGroup - Single Specialty