Organization
LICE CLEANIQUE, LLC.
Active
Other names
South Florida Family Health & Research Centers
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LIDIA E SERRANO (CLINICAL DIRECTOR)
(954) 791-0711
Entity
Organization
Contact information
Practice address
5353 W ATLANTIC AVE, SUITE 400-A, DELRAY BEACH, FL 33484-8102
(561) 495-0166
(561) 381-4581
Mailing address
6971 W SUNRISE BLVD, SUITE 102, PLANTATION, FL 33313-4407
(954) 791-0711
(954) 791-4392
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
HCC8590
FL
261QH0100X
Health Service Clinic/Center
HCC8590
FL
261QM1300X
Multi-Specialty Clinic/Center
HCC8590
FL
261QP2300X
Primary Care Clinic/Center
Primary
HCC8590
FL
261QR1100X
Research Clinic/Center
HCC8590
FL
261QS1000X
Student Health Clinic/Center
HCC8590
FL
Other
Enumeration date
06/10/2009
Last updated
10/03/2011
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