Healthcare Provider Details

I. General information

NPI: 1366313710
Provider Name (Legal Business Name): LAUREN ECKSTEIN MS, LCGC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2025
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1131 N 35TH AVE FL 2
HOLLYWOOD FL
33021-5403
US

IV. Provider business mailing address

1251 SE 7TH AVE APT 104
DANIA BEACH FL
33004-4681
US

V. Phone/Fax

Practice location:
  • Phone: 954-265-6319
  • Fax: 954-276-0166
Mailing address:
  • Phone: 812-212-6457
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: