LICE SOURCE SERVICES INC. NPI 1508092263

NPI Information

NPI: 1508092263
Provider Name: LICE SOURCE SERVICES, INC.

Doing Business As: SOUTH FLORIDA FAMILY HEALTH & RESEARCH CENTERS

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
6971 W SUNRISE BLVD
SUITE #102
PLANTATION, FL
ZIP 33313
Phone: (954) 791-0711
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LICE SOURCE SERVICES, INC. is a primary care clinic center in Plantation, FL. LICE SOURCE SERVICES, INC. NPI is 1508092263. The provider is registered as an organization entity type.
The provider Is Doing Business As South Florida Family Health & Research Centers.

The provider's business location address is:

6971 W SUNRISE BLVD
SUITE #102
PLANTATION, FL
ZIP 33313-407
Phone: (954) 791-0711
Fax: (954) 791-4392

The provider's authorized official is Lidia E Serrano .
The authorized official title is Clinical Director and has the following contact phone number (954) 791-0711.

The enumeration date for this NPI number is 6/8/2009 and was last updated on 10/3/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261Q00000X	Clinic/Center		HCC8589	FLORIDA	No
2	261QH0100X	Clinic/Center	Health Service	HCC8589	FLORIDA	No
3	261QM1300X	Clinic/Center	Multi-Specialty	HCC8589	FLORIDA	No
4	261QS1000X	Clinic/Center	Student Health	HCC8589	FLORIDA	No
5	261QP2300X	Clinic/Center	Primary Care	HCC8589	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001642200	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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