Provider Demographics
NPI:1023428844
Name:LEIGHTON LUGG PROPERTIES LLC
Entity type:Organization
Organization Name:LEIGHTON LUGG PROPERTIES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEIGHTON
Authorized Official - Middle Name:RICARDO
Authorized Official - Last Name:LUGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-204-0632
Mailing Address - Street 1:8431 NW 38TH ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33024-5235
Mailing Address - Country:US
Mailing Address - Phone:954-204-0632
Mailing Address - Fax:
Practice Address - Street 1:8431 NW 38TH ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33024-5235
Practice Address - Country:US
Practice Address - Phone:954-204-0632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-01
Last Update Date:2014-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41976261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health