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General NPI Number Information
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NPI Number | 1316344740
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Entity Type | Organization
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Legal Business Name | LMC HEALTH & WELLNESS CENTER INC.
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 9806 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6141
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Country | US
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Telephone | 786-597-1585
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Fax |
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Provider Business Mailing Address
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Address Line | 9806 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33024
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Country | US
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Telephone | 786-597-1585
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LUIS M CAMPILLO
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Credential |
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Telephone | 786-597-1585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | ME64856
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License Number State | FL
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