Healthcare Provider Details

I. General information

NPI: 1376240861
Provider Name (Legal Business Name): LAMORIA JAVETTA HUGLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2023
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3520 OAKS WAY
POMPANO BEACH FL
33069-5391
US

IV. Provider business mailing address

7510 NW 75TH ST
TAMARAC FL
33321-5141
US

V. Phone/Fax

Practice location:
  • Phone: 305-807-1909
  • Fax:
Mailing address:
  • Phone: 754-207-9816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: