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General NPI Number Information
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NPI Number | 1902145915
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Entity Type | Organization
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Legal Business Name | LHAW LLC
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Dates
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Enumeration Date | 02/11/2013
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Last Update Date | 09/18/2014
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Provider Practice Location Address
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Address Line | 680 2ND AVE N SUITE 304
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City | NAPLES
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State | FL
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Zip | 34102-5753
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Country | US
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Telephone | 239-249-1428
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Fax | 239-529-5491
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Provider Business Mailing Address
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Address Line | 2200 FORREST LN
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City | NAPLES
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State | FL
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Zip | 34102-7621
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Country | US
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Telephone | 239-249-1428
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Fax | 239-529-5491
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MRS. BETH LEVINE
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Credential |
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Telephone | 239-249-1428
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9101564
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | ME72991
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License Number State | FL
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