Individual
ANTOINETTE LACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3170 N FEDERAL HWY STE 100N, LIGHTHOUSE POINT, FL 33064-6881
(954) 304-3565
Mailing address
3170 N FEDERAL HWY STE 100N, LIGHTHOUSE POINT, FL 33064-6881
(954) 304-3565
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
P16000070725
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P16000070725
CORPORATION LICENSE NUMBER
FL
Enumeration date
09/08/2016
Last updated
09/25/2023
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