Provider Demographics
NPI:1962096743
Name:LVH FL TELEHEALTH PLLC
Entity type:Organization
Organization Name:LVH FL TELEHEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF RCM
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:LASICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-559-1378
Mailing Address - Street 1:PO BOX 4458
Mailing Address - Street 2:DEPT 841
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4458
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 CORPORATE SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1941
Practice Address - Country:US
Practice Address - Phone:904-515-5086
Practice Address - Fax:866-541-5354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-23
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder