Provider Demographics
NPI:1487733697
Name:LR HART LLC
Entity type:Organization
Organization Name:LR HART LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:772-571-8657
Mailing Address - Street 1:12416 91ST ST
Mailing Address - Street 2:
Mailing Address - City:FELLSMERE
Mailing Address - State:FL
Mailing Address - Zip Code:32948-5521
Mailing Address - Country:US
Mailing Address - Phone:772-571-8657
Mailing Address - Fax:
Practice Address - Street 1:12416 91ST ST
Practice Address - Street 2:
Practice Address - City:FELLSMERE
Practice Address - State:FL
Practice Address - Zip Code:32948-5521
Practice Address - Country:US
Practice Address - Phone:772-571-8657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN2930672163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-SurgicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLX1619OtherBLUE CROSS