Provider Demographics
NPI:1720962871
Name:HEALING IHN LLC
Entity type:Organization
Organization Name:HEALING IHN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GLORIED
Authorized Official - Middle Name:M
Authorized Official - Last Name:EBSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:863-738-6601
Mailing Address - Street 1:5304 S FLORIDA AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2519
Mailing Address - Country:US
Mailing Address - Phone:863-738-6601
Mailing Address - Fax:863-937-3002
Practice Address - Street 1:5304 S FLORIDA AVE STE 408
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2519
Practice Address - Country:US
Practice Address - Phone:863-738-6601
Practice Address - Fax:863-937-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Multi-Specialty