MEDICARE: LUBERTINA MENARD

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
1	372600000X	Adult Companion	240043	FL

General Provider Information

NPI Number	:	1598588931
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUBERTINA MENARD

Provider Business Mailing Address
First Line	:	2598 E SUNRISE BLVD STE 2104
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3230
Country	:	US
Telephone Number	:	305-813-5330
Fax Number	:

Provider Business Practice Location Address
First Line	:	2598 E SUNRISE BLVD STE 2104
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-3230
Country	:	US
Telephone Number	:	305-813-5330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/07/2024

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Directions to “ LUBERTINA MENARD ” Practice Location

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