Lighthouse Crew
Specialty details in registry · Fort Lauderdale, FL
At a glance
417 Sw 12Th St, Fort Lauderdale, FL 33315-1406
NPPES record updated Sep 17, 2014. Public records can lag behind changes at a practice.
Before you call: a quick checklist
- Are you accepting new patients?
- Do you accept my specific insurance plan?
- Do you provide the service I need at this address?
- Do I need a referral, and what is the earliest appointment?
Insurance participation and appointment availability are not established by these public records.
Practice location
417 Sw 12Th StFort Lauderdale, FL 33315-1406
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 324500000X
- Enumeration date
- Sep 17, 2014
- Record updated
- Sep 17, 2014
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Specialty details in registry
324500000X · Primary
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
417 Sw 12Th StFort Lauderdale, FL 33315-1406
- Phone
- (954) 522-5003
Mailing address
757 SE 17TH ST # 811FORT LAUDERDALE, FL 333162960
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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