Healthcare Provider Details

I. General information

NPI: 1699564856
Provider Name (Legal Business Name): LVG HEALTH GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 N PINE ISLAND RD STE 105
PLANTATION FL
33322-5234
US

IV. Provider business mailing address

1860 N PINE ISLAND RD STE 105
PLANTATION FL
33322-5234
US

V. Phone/Fax

Practice location:
  • Phone: 888-508-6036
  • Fax: 689-304-2180
Mailing address:
  • Phone: 888-508-6036
  • Fax: 689-304-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. FARAH BAUDIN
Title or Position: OFFICE CONSULTANT
Credential:
Phone: 786-277-1621