Las Olas Medical Group & Spa

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME82806 Issued in FL

Legal business name

LAS OLAS MEDICAL GROUP & SPA

Practice address

2607 NE 10TH Ave
Wilton Manors, FL 33334-3707

Phone

(954) 763-1230

Fax

(954) 763-1238

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey S Caron, M.D.

Title

Medical Director

Phone

(954) 763-1230

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• LAS OLAS MEDICAL GROUP Former legal business name

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219708800000",
    "number": "1467472068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 NE 10TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333343707",
            "telephone_number": "954-763-1230",
            "fax_number": "954-763-1238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2607 NE 10TH AVE",
            "city": "WILTON MANORS",
            "state": "FL",
            "postal_code": "333343707",
            "telephone_number": "954-763-1230",
            "fax_number": "954-763-1238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS OLAS MEDICAL GROUP & SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2008-08-26",
        "status": "A",
        "authorized_official_last_name": "CARON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "954-763-1230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME82806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "066841900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAS OLAS MEDICAL GROUP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Richard Dexter Ladner, RPH
• Marc Lalonde, PTA, CKTP
• Lampasas, Inc
• Jason William Lane, M.D.
• Cub Joseph Larkin, M.S., NCC
• Las Olas Urgent Care
• Latinos Salud
• Laurel V. Brown, LLC
• Ashley A Law, MS
• Tiara Lee Leavitt- Celestina

• Family Medicine Physician in Wilton Manors, FL
• Providers in Wilton Manors, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.