# PRIME HEALING CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356984652
- **Authorized official:** MR. TONY OUSTABASSIDIS (CEO)
- **Authorized official phone:** (954) 864-3996

## Contact information

- **Practice address:** 10101 W SAMPLE RD, CORAL SPRINGS, FL 33065-3907
- **Practice address phone:** (954) 864-3996
- **Practice address fax:** (347) 227-1368
- **Mailing address:** 10101 W SAMPLE RD, CORAL SPRINGS, FL 33065-3907
- **Mailing address phone:** (954) 864-3996
- **Mailing address fax:** (347) 227-1368

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/20/2019
- **Last updated:** 10/20/2019