Provider Demographics
NPI:1669876231
Name:LESS INSTITUTE CLINICAL PLLC
Entity type:Organization
Organization Name:LESS INSTITUTE CLINICAL PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-278-1970
Mailing Address - Street 1:1100 W OAKLAND PARK BLVD
Mailing Address - Street 2:#3
Mailing Address - City:WILTON MANORS
Mailing Address - State:FL
Mailing Address - Zip Code:33311-1612
Mailing Address - Country:US
Mailing Address - Phone:954-640-6010
Mailing Address - Fax:
Practice Address - Street 1:1100 W OAKLAND PARK BLVD
Practice Address - Street 2:#3
Practice Address - City:WILTON MANORS
Practice Address - State:FL
Practice Address - Zip Code:33311-1612
Practice Address - Country:US
Practice Address - Phone:954-640-6010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-10
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty