| Id Iii, Llc | |
| 
					4719 N Ocean Dr Lauderdale By The Sea FL 33308-2914  | |
| (954) 933-5937 | |
| Not Available | 
| Full Name | Id Iii, Llc | 
|---|---|
| Speciality | Clinic/center - Dental | 
| Location | 4719 N Ocean Dr, Lauderdale By The Sea, Florida | 
| Authorized Official Name and Position | Italo Lozada (PRESIDENT) | 
| Authorized Official Contact | 6177806312 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Id Iii, Llc 4719 N Ocean Dr Lauderdale By The Sea FL 33308-2914 Ph: (954) 933-5937  | Id Iii, Llc 4719 N Ocean Dr Lauderdale By The Sea FL 33308-2914 Ph: (954) 933-5937  | 
| NPI Number | 1881365930 | 
|---|---|
| Provider Enumeration Date | 09/27/2021 | 
| Last Update Date | 09/27/2021 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1881365930 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary | 
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