Provider Demographics
NPI:1184886459
Name:LIFLEUR, MARTINE (PA-C)
Entity type:Individual
Prefix:
First Name:MARTINE
Middle Name:
Last Name:LIFLEUR
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 WESTON RD
Mailing Address - Street 2:#108
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-3260
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1685 W 49TH ST
Practice Address - Street 2:#1104
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33012-2995
Practice Address - Country:US
Practice Address - Phone:954-205-9559
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9104458363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical