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Individual

LINDSAY BETHEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1255 W 53RD ST, HIALEAH, FL 33012-9001
(305) 819-9232
Mailing address
1255 W 53RD ST, HIALEAH, FL 33012-9001
(305) 819-9232

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
CHS 0607-5608-03
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
230409100
MEDICAID PROVIDER NUMBER
GA
Enumeration date
05/02/2008
Last updated
05/02/2008
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