| Lifespan Health Services Llc | |
|
2295 Nw Corporate Blvd 231 Boca Raton FL 33431-7373 | |
| (561) 995-9762 | |
| (561) 995-9799 |
| Full Name | Lifespan Health Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 2295 Nw Corporate Blvd, Boca Raton, Florida |
| Authorized Official Name and Position | Daniel Lobovits (PRESIDENT) |
| Authorized Official Contact | 5619959762 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Health Services Llc 2295 Nw Corporate Blvd 231 Boca Raton FL 33431-7373 Ph: (561) 995-9762 | Lifespan Health Services Llc 2295 Nw Corporate Blvd 231 Boca Raton FL 33431-7373 Ph: (561) 995-9762 |
| NPI Number | 1457520025 |
|---|---|
| Provider Enumeration Date | 02/27/2008 |
| Last Update Date | 10/07/2008 |
| Medicare PECOS PAC ID | 6305913542 |
|---|---|
| Medicare Enrollment ID | O20080930000321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457520025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TH0100X | Psychologist - Health Service | PY5283 (Florida) | Primary |
| Provider Name | Lisa Faraldo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285882050 PECOS PAC ID: 3971660499 Enrollment ID: I20090326000500 |
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