Healthcare Provider Details

I. General information

NPI: 1316998990
Provider Name (Legal Business Name): LEAH BETH MARCOVITZ ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3702 WASHINGTON ST SUITE 201
HOLLYWOOD FL
33021-8282
US

IV. Provider business mailing address

3715 SW 50TH ST
FORT LAUDERDALE FL
33312-8209
US

V. Phone/Fax

Practice location:
  • Phone: 954-986-1811
  • Fax: 954-986-9452
Mailing address:
  • Phone: 954-989-8947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9184646
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: