1457905671 NPI number — DR BEHLING LLC

Table of content: (NPI 1457905671)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457905671 NPI number — DR BEHLING LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR BEHLING LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LIFERESTORE MD
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457905671
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 SE 2ND STREET, SUITE 2000-PMB #097
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIAMI
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
786-592-6373
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 S DOUGLAS RD STE 880
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORAL GABLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33134-2088
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
786-254-7778
Provider Business Practice Location Address Fax Number:
786-524-2252
Provider Enumeration Date:
07/25/2019

Additional Information

Authorized Official

Authorized Official Last Name:
BEHLING
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
808-271-8385

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com