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NPI Code Detail

MEDICARE: LE RADIANT RECOVERY AND WELLNESS LLC

MEDICARE: LE RADIANT RECOVERY AND WELLNESS 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
13747A0650XAttendant Care Provider

General Provider Information

NPI Number : 1427912096
Entity Type Code : Organization
Provider Name (Legal Business Name) : LE RADIANT RECOVERY AND WELLNESS LLC
Provider Business Mailing Address
First Line : 3440 HOLLYWOOD BLVD STE 415
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6933
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3440 HOLLYWOOD BLVD STE 415
Second Line :
City : HOLLYWOOD
State : FL
Zip : 33021-6933
Country : US
Telephone Number : 954-682-6411
Fax Number :
Authorized Official
Title or Position : OWNER
Name : RAUL BEJERANO
Credential :
Telephone Number : 954-682-6411
Provider Enumeration Date : 12/09/2025
Last Update Date : 12/09/2025

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Directions to “LE RADIANT RECOVERY AND WELLNESS LLC ” Practice Location

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