Provider Demographics
NPI:1225218779
Name:DR. LEA HARRACKSINGH
Entity Type:Organization
Organization Name:DR. LEA HARRACKSINGH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRACKSINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-797-6333
Mailing Address - Street 1:333 NW 70TH AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-2385
Mailing Address - Country:US
Mailing Address - Phone:954-797-6333
Mailing Address - Fax:954-587-6959
Practice Address - Street 1:333 NW 70TH AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-2385
Practice Address - Country:US
Practice Address - Phone:954-797-6333
Practice Address - Fax:954-587-6959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME71598174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9017Medicare PIN
FLG64963Medicare UPIN