MEDICARE: LISA SEID

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1306261144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LISA SEID

Provider Business Mailing Address
First Line	:	3038 N FEDERAL HWY UPPR F2
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1436
Country	:	US
Telephone Number	:	954-544-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	3038 N FEDERAL HWY UPPR F2
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33306-1436
Country	:	US
Telephone Number	:	954-544-0044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/04/2014
Last Update Date	:	03/01/2019

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Directions to “ LISA SEID ” Practice Location

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