| Clsc | |
|
5355 Lyons Rd Coconut Creek FL 33073-2825 | |
| (954) 570-9595 | |
| Not Available |
| Full Name | Clsc |
|---|---|
| Speciality | Family Medicine |
| Location | 5355 Lyons Rd, Coconut Creek, Florida |
| Authorized Official Name and Position | Chantal Bray (ADMINISTRATOR) |
| Authorized Official Contact | 9544181683 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clsc 4855 W. Hillsboro Blvd Ste B2 Coconut Creek FL 33073-4356 Ph: (954) 418-1683 | Clsc 5355 Lyons Rd Coconut Creek FL 33073-2825 Ph: (954) 570-9595 |
| NPI Number | 1538155262 |
|---|---|
| Provider Enumeration Date | 09/27/2005 |
| Last Update Date | 01/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538155262 | NPI | - | NPPES |
| 74562 | Other | FL | MEDICARE PTAN |
| 268799200 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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