Healthcare Provider Details

I. General information

NPI: 1700759974
Provider Name (Legal Business Name): LHA CARE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 E HALLANDALE BEACH BLVD STE 1004
HALLANDALE BEACH FL
33009-4636
US

IV. Provider business mailing address

1250 E HALLANDALE BEACH BLVD STE 1004
HALLANDALE BEACH FL
33009-4636
US

V. Phone/Fax

Practice location:
  • Phone: 954-451-1743
  • Fax: 954-838-5336
Mailing address:
  • Phone: 954-451-1743
  • Fax: 954-838-5336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. FERNANDO A LARACUENTE
Title or Position: EXECUTIVE DIRECTOR
Credential: APRN
Phone: 954-451-1743