Lifetime Health Medical Group Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

LIFETIME HEALTH MEDICAL GROUP INC

Practice address

11410 N Kendall Dr Ste 307
Miami, FL 33176-1031

Phone

(786) 238-7982

Fax

(305) 463-1293

NPI assigned

Aug 6, 2021

Last updated

Aug 6, 2021By 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

Raul Duconger

Title

President

Phone

(786) 238-7982

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628208000000",
    "number": "1750055216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11410 N KENDALL DR STE 307",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761031",
            "telephone_number": "786-238-7982",
            "fax_number": "305-463-1293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11410 N KENDALL DR STE 307",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331761031",
            "telephone_number": "786-238-7982",
            "fax_number": "305-463-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME HEALTH MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-08-06",
        "certification_date": "2021-08-06",
        "status": "A",
        "authorized_official_last_name": "DUCONGER",
        "authorized_official_first_name": "RAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "786-238-7982"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifespan Home Health Care of Miami, LLC
• Lifespan Medical Center LLC
• Lifestream, Inc. (Lifestream Diagnostic)
• Lifestyle Community Services LLC
• Lifetime Care Services LLC
• Lifetime Home Health Care Corp
• Lifetime Senior Care Services, Corp
• Lifetime Solutions Agency, LLC
• Lifetime Solutions Agency, LLC
• Sofia Anna Lifgren, M.D.

• Clinic/Center in Miami, FL
• Providers in Miami, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2021; 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.