Lake's Medical Office

NPI 1295935013 - Clinic/Center - 261QH0100X

NPI Details
NPI 1295935013
Enumeration Date 07/19/2007
Last Updated 07/19/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MANUEL C MANUEL
Position PRESIDENT
Phone (954) 961-8195
Fax
Practice Location
6260 JOHNSON ST
HOLLYWOOD FL, 33024-5932, US
Phone (954) 961-8195
Fax
Business Location
6260 JOHNSON ST
HOLLYWOOD FL, 33024-5932, US
Phone (954) 961-8195
Fax
Toxanomy
Taxonomy Code 261QH0100X
License State Florida
License Number HCC4716
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According to our database, Lake's Medical Office NPI is 1295935013, taxonomy code is 261QH0100X and license number is HCC4716, license state is located at Florida. Lake's Medical Office physically located at 6260 Johnson St, Hollywood FL, 33024-5932. NPI Number 1033115704 has the healthcare provider type.

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1295935013 NPI number is provided on an as is basis without warranty of any kind. 1295935013 is maintained by the National Plan & Provider Enumeration System. The contents of Lake's Medical Office are for informational purposes only.