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General NPI Number Information
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NPI Number | 1104122514
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Entity Type | Organization
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Legal Business Name | NILE R LESTRANGE MD PA
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Dates
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Enumeration Date | 02/02/2011
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 1600 S FEDERAL HWY 10TH FLOOR
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City | POMPANO BEACH
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State | FL
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Zip | 33062-7500
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Country | US
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Telephone | 954-788-9000
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Fax | 954-788-9307
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Provider Business Mailing Address
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Address Line | 1600 S FEDERAL HWY 10TH FLOOR
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City | POMPANO BEACH
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State | FL
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Zip | 33062-7500
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Country | US
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Telephone | 954-788-9000
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Fax | 954-788-9307
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Authorized Official
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Title or Position | PRESIDENT
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Name | NILE R LESTRANGE
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Credential | MD
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Telephone | 954-788-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | ME0012347
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License Number State | FL
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