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NPI Code Detail

MEDICARE: LIVE FREE WELLNESS INSTITUTE LLC

MEDICARE: LIVE FREE WELLNESS INSTITUTE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW4814FL

General Provider Information

NPI Number : 1043763402
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIVE FREE WELLNESS INSTITUTE LLC
Provider Business Mailing Address
First Line : 7709 DAVIE ROAD EXT
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33024-2515
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7709 DAVIE ROAD EXT
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33024-2515
Country : US
Telephone Number : 305-336-1739
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SUZANNE SCHECTER
Credential :
Telephone Number : 305-336-1739
Provider Enumeration Date : 08/02/2016
Last Update Date : 08/02/2016

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Directions to “LIVE FREE WELLNESS INSTITUTE LLC ” Practice Location

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