Life Extension and Wellness Center Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LIFE EXTENSION AND WELLNESS CENTER INC

Practice address

1418 S Federal Hwy
Dania Beach, FL 33004-4349

Phone

(954) 921-9555

Fax

(954) 921-9556

NPI assigned

Dec 8, 2011

Organization subpart

No

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

Authorized official

Name

Laura B Burke

Title

MCC

Phone

(954) 921-9555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1386912079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1418 S FEDERAL HWY",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330044349",
            "telephone_number": "954-921-9555",
            "fax_number": "954-921-9556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1418 S FEDERAL HWY",
            "city": "DANIA BEACH",
            "state": "FL",
            "postal_code": "330044349",
            "telephone_number": "954-921-9555",
            "fax_number": "954-921-9556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE EXTENSION AND WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MCC",
        "authorized_official_telephone_number": "954-921-9555"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joanna Laguerre
• Brandee Lam, PHARMD
• Jeffrey N Landsberg, PT
• Michele Thomas Leete
• Leslie Leveck, RYT
• Lincare Inc. (Lets Breathe Oxygen and Medical)
• Kelsey Littlefield, PT, DPT
• Leticia Llanio Coro
• Mary Louisina Louis
• Richard Frederick Lowy, PHARMACIST

• Internal Medicine Physician in Dania Beach, FL
• Providers in Dania Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.