Provider Demographics
NPI:1811460934
Name:LENCHUS, DEBORAH MEREDITH
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:MEREDITH
Last Name:LENCHUS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14959 SW 35TH ST
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33331-2722
Mailing Address - Country:US
Mailing Address - Phone:954-234-0112
Mailing Address - Fax:
Practice Address - Street 1:7383 N STATE ROAD 7
Practice Address - Street 2:
Practice Address - City:PARKLAND
Practice Address - State:FL
Practice Address - Zip Code:33073-4527
Practice Address - Country:US
Practice Address - Phone:954-753-4492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3295292363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics