Kenbeck LLC

Primary specialty

Ph.D. Medical GeneticsTaxonomy code 170100000X

Legal business name

KENBECK LLC

Practice address

4342 E Tradewinds Ave
Lauderdale by the Sea, FL 33308-5044

Phone

(954) 491-3103

Fax

(954) 491-3105

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Sofiya Johnson

Title

President

Phone

(954) 491-3103

Specialties & licenses 1

Addresses

Other names 1

• THE LIGHT THERAPY INSTITUTE Doing business as

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1437286937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 E TRADEWINDS AVE",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333085044",
            "telephone_number": "954-491-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4342 E TRADEWINDS AVE",
            "city": "LAUDERDALE BY THE SEA",
            "state": "FL",
            "postal_code": "333085044",
            "telephone_number": "954-491-3103",
            "fax_number": "954-491-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENBECK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SOFIYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-491-3103"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE LIGHT THERAPY INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Id III, LLC
• Kimberly Johnson, RD
• Steven Jordan
• Julia Fischetto, Ms,PA
• Linda Louise Keene, MSPT
• Brenda Klee, ARNP
• Natalie Koulouvaris, L.AC.
• Rhoda P Kublickis, MHS, CRDH, FAADH
• Julian Dieter Laumeier, PT
• Roger J Lavine Jr., PSYD.

• Ph.D. Medical Genetics in Lauderdale by the Sea, FL
• Providers in Lauderdale by the Sea, FL by specialty
• Ph.D. Medical Genetics in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.