| Lux Medical Health Center Inc | |
|
1200 S Federal Hwy Hollywood FL 33020-6030 | |
| (786) 715-1059 | |
| (954) 443-8496 |
| Full Name | Lux Medical Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1200 S Federal Hwy, Hollywood, Florida |
| Authorized Official Name and Position | Luis Manuel Gonzalez (PRESIDENT) |
| Authorized Official Contact | 7867151059 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lux Medical Health Center Inc 1200 S Federal Hwy Hollywood FL 33020-6030 Ph: (786) 715-1059 | Lux Medical Health Center Inc 1200 S Federal Hwy Hollywood FL 33020-6030 Ph: (786) 715-1059 |
| NPI Number | 1467995894 |
|---|---|
| Provider Enumeration Date | 12/03/2016 |
| Last Update Date | 08/03/2021 |
| Medicare PECOS PAC ID | 9830451467 |
|---|---|
| Medicare Enrollment ID | O20180320001313 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467995894 | NPI | - | NPPES |
| 023990400 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ana Tascheret |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689946758 PECOS PAC ID: 3779704465 Enrollment ID: I20141022000567 |
| Provider Name | Luis M Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942555107 PECOS PAC ID: 1850614983 Enrollment ID: I20141222002164 |
| Provider Name | Jefferson Van Didier Ganthier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245793983 PECOS PAC ID: 1052700531 Enrollment ID: I20211123001200 |
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