Provider Demographics
NPI:1780838045
Name:LPMG INC
Entity Type:Organization
Organization Name:LPMG INC
Other - Org Name:LONGWOOD HEALING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNETT
Authorized Official - Suffix:
Authorized Official - Credentials:AP
Authorized Official - Phone:407-265-1888
Mailing Address - Street 1:212 W BAY AVE
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-4126
Mailing Address - Country:US
Mailing Address - Phone:407-265-1888
Mailing Address - Fax:407-265-9581
Practice Address - Street 1:212 W BAY AVE
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-4126
Practice Address - Country:US
Practice Address - Phone:407-265-1888
Practice Address - Fax:407-265-9581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-12
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty