Organization
LAKE WORTH CARDIOLOGY CONSULTANTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADELINE ETIENNE (MANAGER)
(718) 972-9712
Entity
Organization
Contact information
Practice address
4849 LAKE WORTH RD, GREENACRES, FL 33463-3455
(561) 433-4446
(561) 433-3026
Mailing address
4849 LAKE WORTH RD, GREENACRES, FL 33463-3455
(561) 202-6064
(561) 202-6089
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME102740
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336161603
NATIONAL PROVIDER ID
FL
Enumeration date
10/13/2008
Last updated
03/28/2009
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