Provider Demographics
NPI:1942950217
Name:LDMS LLC
Entity Type:Organization
Organization Name:LDMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:SANTANDREA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:786-210-4266
Mailing Address - Street 1:2246 QUAIL ROOST DR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33327-1447
Mailing Address - Country:US
Mailing Address - Phone:786-210-4266
Mailing Address - Fax:
Practice Address - Street 1:1725 MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-3667
Practice Address - Country:US
Practice Address - Phone:786-210-4266
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty