Healthcare Provider Details

I. General information

NPI: 1528760675
Provider Name (Legal Business Name): LYNZEE IVY JANOWITZ DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1643 E HARMONY LAKE CIR
DAVIE FL
33324-7111
US

IV. Provider business mailing address

1643 E HARMONY LAKE CIR
DAVIE FL
33324-7111
US

V. Phone/Fax

Practice location:
  • Phone: 954-520-2416
  • Fax:
Mailing address:
  • Phone: 954-520-2416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: