| Life Extension And Wellness Center Inc | |
|
1418 S Federal Hwy Dania Beach FL 33004-4349 | |
| (954) 921-9555 | |
| (954) 921-9556 |
| Full Name | Life Extension And Wellness Center Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1418 S Federal Hwy, Dania Beach, Florida |
| Authorized Official Name and Position | Laura B Burke (MCC) |
| Authorized Official Contact | 9549219555 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Extension And Wellness Center Inc 1418 S Federal Hwy Dania Beach FL 33004-4349 Ph: (954) 921-9555 | Life Extension And Wellness Center Inc 1418 S Federal Hwy Dania Beach FL 33004-4349 Ph: (954) 921-9555 |
| NPI Number | 1386912079 |
|---|---|
| Provider Enumeration Date | 12/08/2011 |
| Last Update Date | 11/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386912079 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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