Organization
ENHANCED LIFESTYLE SENIOR HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID GONZALEZ (CREDENTIALING)
(813) 453-6179
Entity
Organization
Contact information
Practice address
2125 HARDEN BLVD, LAKELAND, FL 33803-5918
(863) 838-8114
(863) 345-8793
Mailing address
2125 HARDEN BLVD, LAKELAND, FL 33803-5918
(863) 838-8114
(863) 345-8793
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
01/26/2022
Last updated
05/06/2022
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