LIFE RENEWING THERAPEUTIC CENTER, INC. (NPI# 1609169119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609169119 |
| Entity Type | Organization |
| Organization Name | LIFE RENEWING THERAPEUTIC CENTER, INC. |
| Practice Address |
2699 Stirling Rd Fort Lauderdale FL 33312-6517 |
| Mailing Address |
1401 Sw 66th Ter Plantation FL 33317-5131 |
| Practice Telephone | 9549663741 |
| Mailing Telephone | 9543363512 |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2011-05-17 |
| Authorized Official Name | DR. LAURA MARIE KUBAT (PRESIDENT) |
| Authorized Official Telephone | 9543363512 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
MH7747 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 003104400 | 05 |
| Street Address |
2699 STIRLING RD |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33312-6517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689675290 | Mark T Lang | Social Worker | 2699 Stirling Rd, Suite C-304, Fort Lauderdale, FL 33312-6517 | 2005-08-04 |
| 1063856938 | Drt Behavioral Services Pllc | Psychiatry & Neurology | 2699 Stirling Rd, Suite C407, Fort Lauderdale, FL 33312 | 2013-04-23 |
| 1629335294 | Premier Spine Center,inc | Clinic/Center | 2699 Stirling Rd, Suite C-405, Fort Lauderdale, FL 33312-6517 | 2012-04-19 |
| 1598035370 | Russel S. Palmer M.d.,p.a. | Specialist | 2699 Stirling Rd, Suite B101, Fort Lauderdale, FL 33312-6517 | 2012-01-10 |
| 1841588779 | Nooshin Zolfaghari D.p.m., P.a. | Podiatrist | 2699 Stirling Rd, Suite A, Fort Lauderdale, FL 33312-6517 | 2011-07-12 |
| 1184918369 | Donna Lynn Desmarais | Counselor | 2699 Stirling Rd, Suite C-307, Fort Lauderdale, FL 33312-6517 | 2011-06-05 |
| 1104121870 | Nooshin Zolfaghari | Podiatrist | 2699 Stirling Rd, Suite A301, Fort Lauderdale, FL 33312-6517 | 2011-01-11 |
| 1295052660 | Gladys Blumenstine | Counselor | 2699 Stirling Rd, Suite B304, Fort Lauderdale, FL 33312-6517 | 2010-04-26 |
| 1104053750 | Robert Nguyen Dpm LLC | Podiatrist | 2699 Stirling Rd, Suite A301/302, Fort Lauderdale, FL 33312-6517 | 2009-06-22 |
| 1225293442 | Robert Nguyen | Podiatrist | 2699 Stirling Rd, Suite A301/302, Fort Lauderdale, FL 33312-6517 | 2008-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679112965 | Krista Moreno | Marriage & Family Therapist | 2699 Stirling Road Building C Suite 403e, Fort Lauderdale, FL 33312 | 2020-01-03 |
| 1700428026 | Caring Village of Lauderdale LLC | Assisted Living Facility | 408-412 Sw 7th Ave, Fort Lauderdale, FL 33312 | 2019-10-09 |
| 1548742356 | Inspire Acupuncture | Acupuncturist | 1000 Riverside Drive, Fort Lauderdale, FL 33312 | 2018-08-29 |
| 1447762919 | Daniel Desta Bekele | General Practice | 1001 W Las Olas Blvd Apt 4, Fort Lauderdale, FL 33312 | 2017-10-24 |
| 1649798653 | Angel Luis Perez | Nurse Practitioner | 3041 Sw 47 Street, Fort Lauderdale, FL 33312 | 2017-08-30 |
| 1902322738 | Ashley Ingrid Rini | Dentist | 1620 Sw 33rd Ave, Fort Lauderdale, FL 33312 | 2017-08-14 |
| 1548794993 | Elise Cruz | Nurse Practitioner | 3301 Sw 16th Street, Fort Lauderdale, FL 33312 | 2017-04-12 |
| 1619415924 | Antoinette Battle | Nurse Practitioner | 3470 Sw 19th Street, Fort Lauderdale, FL 33312 | 2017-02-07 |
| 1902344252 | Melissa Miller | Counselor | 2962 Southwest 26th Terrace, 204, Fort Lauderale, FL 33312 | 2017-02-07 |
| 1164975934 | Brandon Nieves Stella | Technician, Other | 620 Sw 14th Ter, Fort Lauderdale, FL 33312 | 2016-07-28 |
| Find all providers in zip 33312 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275134066 | Hyacinth Anne Morgan | Counselor | 1001 W Cypress Creek Rd Ste 302s, Fort Lauderdale, FL 33309-1950 | 2020-11-06 |
| 1871192203 | Kamari L Pasley | Counselor | 1900 Nw 16th Ct, Fort Lauderdale, FL 33311-4639 | 2020-10-17 |
| 1134746829 | Chinyere Tunsill | Counselor | 1000 Long Island Ave, Fort Lauderdale, FL 33312-2674 | 2020-06-29 |
| 1750906848 | Darcy Holm | Counselor | 3000 N Federal Hwy Ste 5, Fort Lauderdale, FL 33306-1416 | 2020-06-15 |
| 1356977078 | Herz Counseling Group, LLC | Counselor | 4390 N Federal Hwy Ste 208, Fort Lauderdale, FL 33308-5200 | 2020-03-13 |
| 1558997346 | Paulina Scaturro | Counselor | 4413 Ne 21st Ave, Fort Lauderdale, FL 33308-5603 | 2020-03-12 |
| 1144855925 | Victoria Baca | Counselor | 501 Ne 5th Ter Apt 314, Fort Lauderdale, FL 33301-0014 | 2020-03-11 |
| 1184254476 | Shaira A. Shah | Counselor | 2699 Stirling Rd Ste C307, Fort Lauderdale, FL 33312-6564 | 2020-01-25 |
| 1194364893 | Jennifer Tiech | Counselor | 2901 W Cypress Creek Rd Ste 123124, Fort Lauderdale, FL 33309-1730 | 2019-12-27 |
| 1205475167 | Tara Yombor | Counselor | 545 Sw 18th Ave Unit 34, Fort Lauderdale, FL 33312-7704 | 2019-12-24 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33312 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.