Provider Demographics
NPI:1174244545
Name:AXIS HEALTH SERVICES LLC
Entity type:Organization
Organization Name:AXIS HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AYOSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BALART MEJIAS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:786-539-8305
Mailing Address - Street 1:13876 SW 56TH ST STE 145
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-6021
Mailing Address - Country:US
Mailing Address - Phone:786-539-8305
Mailing Address - Fax:
Practice Address - Street 1:2720 SW 97TH AVE STE C-105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33165-2677
Practice Address - Country:US
Practice Address - Phone:786-332-4330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty