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General NPI Number Information
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NPI Number | 1811473994
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Entity Type | Individual
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Provider Name | RADCLIFFE LLOYD NATHAN MS
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Gender | Male
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Dates
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Enumeration Date | 07/12/2018
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Last Update Date | 07/12/2018
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Provider Practice Location Address
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Address Line | 2814 S US HIGHWAY 1 STE D4
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City | FORT PIERCE
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State | FL
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Zip | 34982-8110
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Country | US
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Telephone | 772-489-4726
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Fax |
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Provider Business Mailing Address
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Address Line | 5219 NW EDGARTON TER
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City | PORT SAINT LUCIE
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State | FL
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Zip | 34983-1439
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Country | US
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Telephone | 772-879-2703
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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