Provider Demographics
NPI:1487148706
Name:PERFECT BALANCE HEALTHCARE, PLLC
Entity type:Organization
Organization Name:PERFECT BALANCE HEALTHCARE, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NANDITA
Authorized Official - Middle Name:SARAH
Authorized Official - Last Name:KOODIE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:855-724-8786
Mailing Address - Street 1:1293 N. UNIVERSITY DR.
Mailing Address - Street 2:# 153
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071
Mailing Address - Country:US
Mailing Address - Phone:855-724-8786
Mailing Address - Fax:855-724-8786
Practice Address - Street 1:7500 LIVE OAK DR.
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065
Practice Address - Country:US
Practice Address - Phone:855-724-8786
Practice Address - Fax:855-724-8786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS52571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty