Icon Medical Centers, LLC

NPI #1073108692 in Hollywood, Florida

Provider Information

NPI Number: 1073108692
Entity Type: Organization
Organization Name: Icon Medical Centers, LLC
Subpart: Yes (part of a larger organization)
Parent Organization: ICON MEDICAL CENTERS, LLC
Primary Specialty: Chiropractor
Enumeration Date: Mar 5, 2021
Last Updated: Mar 5, 2021

Practice Location

Address: 3625 HOLLYWOOD BLVD
City: Hollywood
State: Florida
ZIP Code: 33021-6854
Phone: (954) 987-8400

Authorized Official

Name: EDWARD J LUCAS, MD
Title: MANAGER
Phone: (352) 694-6331

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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