| Lighthouse Medical Center, Inc. | |
|
4 Ne 4th Ave Pompano Beach FL 33060-6630 | |
| (754) 222-6642 | |
| Not Available |
| Full Name | Lighthouse Medical Center, Inc. |
|---|---|
| Speciality | General Practice |
| Location | 4 Ne 4th Ave, Pompano Beach, Florida |
| Authorized Official Name and Position | Jason Cheshire (PRESIDENT) |
| Authorized Official Contact | 9549431044 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lighthouse Medical Center, Inc. 4 Ne 4th Ave Pompano Beach FL 33060-6630 Ph: () - | Lighthouse Medical Center, Inc. 4 Ne 4th Ave Pompano Beach FL 33060-6630 Ph: (754) 222-6642 |
| NPI Number | 1003382300 |
|---|---|
| Provider Enumeration Date | 10/15/2018 |
| Last Update Date | 05/26/2020 |
| Medicare PECOS PAC ID | 2668706995 |
|---|---|
| Medicare Enrollment ID | O20190620001100 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003382300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Jason Cheshire |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1366438319 PECOS PAC ID: 2264410877 Enrollment ID: I20040714000063 |
| Provider Name | Carrie D Culpepper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386107407 PECOS PAC ID: 0749523165 Enrollment ID: I20190528000757 |
| Provider Name | Nithya Mathai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710462791 PECOS PAC ID: 2163756404 Enrollment ID: I20190620001834 |
| Provider Name | Elizabeth Bednar |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1548802143 PECOS PAC ID: 2365814506 Enrollment ID: I20230215002894 |
| Provider Name | Jennifer Nardella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235808361 PECOS PAC ID: 5890150767 Enrollment ID: I20230427002051 |
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