Organization
LONGEVITY AND WELLBEING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA SKIRVING (PRESIDENT)
(786) 350-0576
Entity
Organization
Contact information
Practice address
10160 NW 6TH ST, PEMBROKE PINES, FL 33026-3983
(786) 350-0576
Mailing address
10160 NW 6TH ST, PEMBROKE PINES, FL 33026-3983
(786) 350-0576
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107978600
—
FL
Enumeration date
05/13/2021
Last updated
05/19/2021
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