Provider Demographics
NPI:1922834985
Name:HEALTHY MILESTONES FAMILY PRACTICE
Entity type:Organization
Organization Name:HEALTHY MILESTONES FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOVIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-654-9474
Mailing Address - Street 1:10151 HENBURY ST # SR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32832-7115
Mailing Address - Country:US
Mailing Address - Phone:321-666-1323
Mailing Address - Fax:
Practice Address - Street 1:10151 HENBURY ST # SR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32832-7115
Practice Address - Country:US
Practice Address - Phone:321-666-1323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:17000187133
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty