Organization
BANYAN INTEGRATIVE HEALTH SERVICES, LLC
Active
Organization
BANYAN INTEGRATIVE HEALTH SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FERNANDO MIRANDA PT (CEO)
(561) 317-1872
Entity
Organization
Contact information
Practice address
2324 S CONGRESS AVE STE 1A, PALM SPRINGS, FL 33406-7667
(561) 408-0903
(561) 408-0905
Mailing address
2324 S CONGRESS AVE STE 1A, PALM SPRINGS, FL 33406-7667
(561) 408-0903
(561) 408-0905
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
—
—
207Q00000X
Family Medicine Physician
—
—
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
11/12/2020
Last updated
12/10/2020
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