Organization
BALANCED LIFE THERAPY CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANASTASIA L MALDONADO LMT (PRESIDENT)
(813) 374-9052
Entity
Organization
Contact information
Practice address
1913 W SLIGH AVE, TAMPA, FL 33604-5813
(813) 374-9052
(813) 374-9053
Mailing address
1913 W SLIGH AVE, TAMPA, FL 33604-5813
(813) 374-9052
(813) 374-9053
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA26724
FL
Other
Enumeration date
02/28/2009
Last updated
02/28/2009
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