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General NPI Number Information
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NPI Number | 1386275840
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Entity Type | Individual
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Provider Name | JAMES WALTER LOFTON III APRN
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Gender | Male
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Dates
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Enumeration Date | 02/03/2020
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 13762 W STATE ROAD 84 STE 136
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City | DAVIE
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State | FL
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Zip | 33325-5305
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Country | US
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Telephone | 954-548-1568
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Fax | 954-827-7945
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Provider Business Mailing Address
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Address Line | 13935 S CYPRESS COVE CIR
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City | DAVIE
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State | FL
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Zip | 33325-6742
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Country | US
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Telephone | 954-548-1568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | XXXXXX
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11006289
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License Number State | FL
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