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General NPI Number Information
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NPI Number | 1235954363
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Entity Type | Organization
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Legal Business Name | LIST HEALTH LLC
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 201 E SAMPLE RD
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City | DEERFIELD BEACH
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State | FL
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Zip | 33064-3502
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Country | US
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Telephone | 954-473-7575
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Fax |
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Provider Business Mailing Address
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Address Line | 2436 N FEDERAL HWY UNIT 135
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City | LIGHTHOUSE POINT
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State | FL
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Zip | 33064-6854
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Country | US
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Telephone | 773-241-1269
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASSANDRA LIST
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Credential | MD
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Telephone | 773-241-1269
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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