Provider Demographics
NPI:1184802894
Name:SEVEN SPRINGS MEDI SPA
Entity type:Organization
Organization Name:SEVEN SPRINGS MEDI SPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:727-599-9819
Mailing Address - Street 1:2154 DUCK SLOUGH BLVD
Mailing Address - Street 2:STE. 2
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655
Mailing Address - Country:US
Mailing Address - Phone:727-375-7578
Mailing Address - Fax:727-375-7568
Practice Address - Street 1:2152 DUCK SLOUGH BLVD
Practice Address - Street 2:2
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655
Practice Address - Country:US
Practice Address - Phone:727-375-7578
Practice Address - Fax:727-375-7568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty