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General NPI Number Information
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NPI Number | 1184067365
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Entity Type | Organization
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Legal Business Name | LG NP SERVICES LLC
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Dates
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Enumeration Date | 04/08/2013
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Last Update Date | 04/08/2013
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Provider Practice Location Address
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Address Line | 8900 N KENDALL DR
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City | MIAMI
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State | FL
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Zip | 33176-2118
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Country | US
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Telephone | 305-596-1960
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Fax |
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Provider Business Mailing Address
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Address Line | 8701 SW 141ST ST APT H8
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City | PALMETTO BAY
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State | FL
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Zip | 33176-7243
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Country | US
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Telephone | 305-968-6480
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER BRUNO
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Credential | ARNP-C
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Telephone | 305-968-6480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | ARNP9208207
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License Number State | FL
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