Healthcare Provider Details

I. General information

NPI: 1184067365
Provider Name (Legal Business Name): LG NP SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8900 N KENDALL DR
MIAMI FL
33176-2118
US

IV. Provider business mailing address

8701 SW 141ST ST APT H8
PALMETTO BAY FL
33176-7243
US

V. Phone/Fax

Practice location:
  • Phone: 305-596-1960
  • Fax:
Mailing address:
  • Phone: 305-968-6480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberARNP9208207
License Number StateFL

VIII. Authorized Official

Name: JENNIFER BRUNO
Title or Position: PRESIDENT
Credential: ARNP-C
Phone: 305-968-6480