Organization
ICON MEDICAL CENTERS, LLC
Active
Parent organization
ICON MEDICAL CENTERS, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
ICON MEDICAL CENTERS, LLC
Authorized official
EDWARD J LUCAS MD (MANAGER)
(352) 694-6331
Entity
Organization
Contact information
Practice address
3625 HOLLYWOOD BLVD, HOLLYWOOD, FL 33021-6854
(954) 987-8400
(352) 694-6338
Mailing address
232 SW 8TH ST, MIAMI, FL 33130-3514
(305) 858-8845
(352) 694-6338
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
03/05/2021
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