Healthcare Provider Details

I. General information

NPI: 1427964105
Provider Name (Legal Business Name): LYDIA LAMARRE JOSEPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1950 SW 69TH AVE APT 103
PEMBROKE PINES FL
33023-2688
US

IV. Provider business mailing address

1950 SW 69TH AVE APT 103
PEMBROKE PINES FL
33023-2688
US

V. Phone/Fax

Practice location:
  • Phone: 954-310-4856
  • Fax:
Mailing address:
  • Phone: 954-310-4856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: