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General NPI Number Information
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NPI Number | 1336588276
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Entity Type | Organization
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Legal Business Name | LAKEVIEW MEDICAL CENTER, INC.
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Dates
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Enumeration Date | 06/24/2013
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Last Update Date | 06/24/2013
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Provider Practice Location Address
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Address Line | 3600 RED RD STE 601A
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City | MIRAMAR
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State | FL
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Zip | 33025-6016
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Country | US
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Telephone | 954-391-8529
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Fax | 954-342-9479
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Provider Business Mailing Address
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Address Line | 3600 RED RD STE 601A
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City | MIRAMAR
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State | FL
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Zip | 33025-6016
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Country | US
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Telephone | 954-391-8529
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Fax | 954-342-9479
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | MS. DIULYS MARTINEZ
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Credential |
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Telephone | 954-391-8529
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | HCC10683
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License Number State | FL
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