Organization
LIFE EQUITY HEALTHCARE LLC
Active
Organization
LIFE EQUITY HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KORITA SHERELLE JOHNSON APRN (OWNER NURSE PRACTITIONER)
(305) 492-5175
Entity
Organization
Contact information
Practice address
1931 NW 150TH AVE STE 269, PEMBROKE PINES, FL 33028-2884
(786) 372-0053
Mailing address
710 SW 64TH WAY, PEMBROKE PINES, FL 33023-1540
(305) 492-5175
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
07/02/2020
Last updated
07/02/2020
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