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General NPI Number Information
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NPI Number | 1689759680
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Entity Type | Organization
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Legal Business Name | LAKE WORTH FIRE DEPARTMENT
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1020 LUCERNE AVE
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City | LAKE WORTH
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State | FL
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Zip | 33460-3713
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Country | US
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Telephone | 561-586-1711
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 LUCERNE AVE
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City | LAKE WORTH
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State | FL
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Zip | 33460-3713
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | PAUL BLOCKSON
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Credential |
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Telephone | 561-586-1711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 2747
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License Number State | FL
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