Provider Demographics
NPI:1164897336
Name:LVOVSKY, INNA (PT)
Entity Type:Individual
Prefix:
First Name:INNA
Middle Name:
Last Name:LVOVSKY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1025 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:STE # 12
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4478
Mailing Address - Country:US
Mailing Address - Phone:305-798-8454
Mailing Address - Fax:
Practice Address - Street 1:1025 E HALLANDALE BEACH BLVD
Practice Address - Street 2:STE # 12
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-4478
Practice Address - Country:US
Practice Address - Phone:305-798-8454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-14
Last Update Date:2015-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT22427174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist