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General NPI Number Information
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NPI Number | 1457520025
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Entity Type | Organization
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Legal Business Name | LIFESPAN HEALTH SERVICES LLC
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 2295 NW CORPORATE BLVD 231
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City | BOCA RATON
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State | FL
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Zip | 33431-7373
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Country | US
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Telephone | 561-995-9762
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Fax | 561-995-9799
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Provider Business Mailing Address
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Address Line | 2295 NW CORPORATE BLVD 231
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City | BOCA RATON
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State | FL
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Zip | 33431-7373
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Country | US
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Telephone | 561-995-9762
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Fax | 561-995-9799
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DANIEL LOBOVITS
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Credential | PH.D.
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Telephone | 561-995-9762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | PY5283
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License Number State | FL
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