Provider Demographics
NPI:1336490960
Name:LFT MANAGEMENT, INC.
Entity Type:Organization
Organization Name:LFT MANAGEMENT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MISS
Authorized Official - First Name:LOR
Authorized Official - Middle Name:FAYEZ
Authorized Official - Last Name:TANOUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-963-6530
Mailing Address - Street 1:4030 SHERIDAN ST
Mailing Address - Street 2:STE A
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3564
Mailing Address - Country:US
Mailing Address - Phone:954-963-6530
Mailing Address - Fax:954-963-8587
Practice Address - Street 1:4030 SHERIDAN ST
Practice Address - Street 2:STE A
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3564
Practice Address - Country:US
Practice Address - Phone:954-963-6530
Practice Address - Fax:954-963-8587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-22
Last Update Date:2012-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization