Healthcare Provider Details

I. General information

NPI: 1881657898
Provider Name (Legal Business Name): BRUCE ALLAN LENES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N STATE ROAD 7
LAUDERHILL FL
33313-5006
US

IV. Provider business mailing address

11340 WAYNE DR
COOPER CITY FL
33026-3737
US

V. Phone/Fax

Practice location:
  • Phone: 954-777-2580
  • Fax: 954-777-2558
Mailing address:
  • Phone: 954-431-2786
  • Fax: 954-777-2558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License NumberME 29726
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: