Organization Name: | LIFETIME FAMILY MEDICINE LLC |
NPI Number: | 1528082948 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARLENE WOLF (PHYSICIAN OWNER) |
Mailing Address: | 9750 Nw 33rd St Suite 220 Coral Springs |
State: | FL US |
Postal Code: | 330654042 |
Phone Number: | 9547552121 |
Fax Number: | 9547552224 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 02/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 33982 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |