Provider Demographics
NPI:1750189296
Name:LATTOUF, MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:LATTOUF
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6586 HYPOLUXO RD STE 218
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7678
Mailing Address - Country:US
Mailing Address - Phone:561-376-5223
Mailing Address - Fax:
Practice Address - Street 1:6586 HYPOLUXO RD STE 218
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-7678
Practice Address - Country:US
Practice Address - Phone:561-376-5223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health