LICE SOURCE SERVICES, INC.
Ambulatory Health in Fort Lauderdale, FL

License number
Florida HCC8589
Category
Ambulatory Health
Type
Clinic/Center
License number
Florida HCC8589
Category
Ambulatory Health
Type
Health Service
License number
Florida HCC8589
Category
Ambulatory Health
Type
Multi-Specialty
License number
Florida HCC8589
Category
Ambulatory Health
Type
Primary Care
License number
Florida HCC8589
Category
Ambulatory Health
Type
Student Health
Owner
Name: MRS. LIDIA E SERRANO
Title: CLINICAL DIRECTOR
Phone: (954) 791-0711
Address
Address
6971 W Sunrise Blvd Suite #102, Fort Lauderdale, FL 33313
National Provider ID: 1508092263
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about LICE SOURCE SERVICES, INC. at bizstanding.com

LICE SOURCE SERVICES, INC

6971 W Sunrise Blvd STE 102, Ft Lauderdale, FL 33313

Status:
Inactive
Inactive reason:
REINSTATEMENT
Registration:
Jan 27, 1998
Inactive since:
Nov 14, 2013
State ID:
P98000008380
Business type:
Florida Profit Corporation
President, Treasurer, Secretary, Directors:
Timothy H Rivera (President, Secretary), 6971 W Sunrise Blvd, Ft Lauderdale, FL 33313 (Physical),Lidia Serrano President, Treasurer, Secretary, Director, inactive
EIN:
650810436

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