Healthcare Provider Details

I. General information

NPI: 1477121515
Provider Name (Legal Business Name): LYNETTE LACOURT PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 06/15/2021
Certification Date: 06/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3599 W HILLSBORO BLVD
DEERFIELD BEACH FL
33442-9404
US

IV. Provider business mailing address

11677 NW 3RD DR
CORAL SPRINGS FL
33071-5021
US

V. Phone/Fax

Practice location:
  • Phone: 954-333-5215
  • Fax:
Mailing address:
  • Phone: 787-974-5941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS55874
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: