Provider Demographics
NPI:1316931454
Name:NATOCHY, LOIS E
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:E
Last Name:NATOCHY
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 1:10320 NW 16TH ST
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-6617
Mailing Address - Country:US
Mailing Address - Phone:954-472-9043
Mailing Address - Fax:954-472-9043
Practice Address - Street 1:10320 NW 16TH ST
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-6617
Practice Address - Country:US
Practice Address - Phone:954-472-9043
Practice Address - Fax:954-472-9043
Is Sole Proprietor?:No
Enumeration Date:2005-09-05
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2049174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE7687Medicare ID - Type Unspecified