# L & M MEDICAL CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932375524
- **Authorized official:** CHOLPON SABYROVA (MANAGER)
- **Authorized official phone:** (954) 239-0578

## Contact information

- **Practice address:** 2100 E HALLANDALE BEACH BLVD, STE 202, HALLANDALE BEACH, FL 33009-3765
- **Practice address phone:** (954) 239-0578
- **Practice address fax:** (954) 239-0582
- **Mailing address:** 2100 E HALLANDALE BEACH BLVD, STE 202, HALLANDALE BEACH, FL 33009-3765
- **Mailing address phone:** (954) 239-0578
- **Mailing address fax:** (954) 239-0582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2008
- **Last updated:** 07/18/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 02466B | MEDICARE | — |