Life Connect Foundation Inc | |
3001 Nw 49th Ave Ste 308 Lauderdale Lakes FL 33313-7263 | |
(954) 391-7319 | |
Not Available |
Full Name | Life Connect Foundation Inc |
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Speciality | Clinic/Center |
Location | 3001 Nw 49th Ave Ste 308, Lauderdale Lakes, Florida |
Authorized Official Name and Position | Macdaline Sanz (PRESIDENT) |
Authorized Official Contact | 9543917319 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Life Connect Foundation Inc 3001 Nw 49th Ave Ste 308 Lauderdale Lakes FL 33313-7263 Ph: (954) 391-7319 | Life Connect Foundation Inc 3001 Nw 49th Ave Ste 308 Lauderdale Lakes FL 33313-7263 Ph: (954) 391-7319 |
NPI Number | 1881207900 |
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Provider Enumeration Date | 08/28/2020 |
Last Update Date | 08/21/2023 |
Medicare PECOS PAC ID | 8729484969 |
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Medicare Enrollment ID | O20210913003531 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881207900 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Kumar Rajagopalan |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1841267796 PECOS PAC ID: 1850323676 Enrollment ID: I20050901000176 |
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