| Lords Medical Group | |
|
661 Sw 3rd Ave Pompano Beach FL 33060-8384 | |
| (954) 771-3685 | |
| (954) 771-3685 |
| Full Name | Lords Medical Group |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 661 Sw 3rd Ave, Pompano Beach, Florida |
| Authorized Official Name and Position | Jeffrey Allen Middleton (PRESIDENT) |
| Authorized Official Contact | 9547713685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lords Medical Group 661 Sw 3rd Ave Pompano Beach FL 33060-8384 Ph: (954) 771-3685 | Lords Medical Group 661 Sw 3rd Ave Pompano Beach FL 33060-8384 Ph: (954) 771-3685 |
| NPI Number | 1154917706 |
|---|---|
| Provider Enumeration Date | 12/17/2020 |
| Last Update Date | 09/13/2021 |
| Medicare PECOS PAC ID | 0143618967 |
|---|---|
| Medicare Enrollment ID | O20211028000619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154917706 | NPI | - | NPPES |
| 551532 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | (* (Not Available)) | Primary |
| Provider Name | Jeffrey A Middleton |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1730214446 PECOS PAC ID: 7517983968 Enrollment ID: I20051015000017 |
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