Life Extension and Wellness Center INC
NPI #1386912079 in Dania Beach, Florida
Provider Information
- NPI Number
- 1386912079
- Entity Type
- Organization
- Organization Name
- Life Extension and Wellness Center INC
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Dec 8, 2011
- Last Updated
- Nov 21, 2016
Practice Location
- Address
- 1418 S FEDERAL HWY
- City
- Dania Beach
- State
- Florida
- ZIP Code
- 33004-4349
- Phone
- (954) 921-9555
Authorized Official
- Name
- LAURA B BURKE
- Title
- MCC
- Phone
- (954) 921-9555
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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