Life Equity Healthcare LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

LIFE EQUITY HEALTHCARE LLC

Practice address

1931 NW 150TH Ave Ste 269
Pembroke Pines, FL 33028-2884

Phone

(786) 372-0053

NPI assigned

Jul 2, 2020

Last updated

Jul 2, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Korita Sherelle Johnson, APRNNPI 1528475183

Title

Owner Nurse Practitioner

Phone

(305) 492-5175

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Korita Johnson, APRN

  • Primary Care Nurse Practitioner
  • West Palm Beach, FL
  • NPI 1528475183
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593648000000",
    "number": "1174140438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 SW 64TH WAY",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330231540",
            "telephone_number": "305-492-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1931 NW 150TH AVE STE 269",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330282884",
            "telephone_number": "786-372-0053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE EQUITY HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KORITA",
        "authorized_official_middle_name": "SHERELLE",
        "authorized_official_title_or_position": "OWNER NURSE PRACTITIONER",
        "authorized_official_telephone_number": "305-492-5175",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aaron You Li, M.D.
• Qun Liang
• Paul Anthony Licata, PA-C
• Gary J Lieberman, MD
• Melanie Liermo
• Lifeline Counseling Center
• Lifeline Counseling, Inc.
• Lifesource Homecare Inc
• Lifestyle Behavior LLC
• Lifestyle Opticians

• Health Service Clinic/Center in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Health Service Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.