Basic Information
| Provider Information | |||||||||
| NPI: | 1558471615 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAMBIE | ||||||||
| FirstName: | D. | ||||||||
| MiddleName: | IANTHE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., M.P.H. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LAMBIE | ||||||||
| OtherFirstName: | IANTHE | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | MD, MPH | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 105 NE 3RD ST | ||||||||
| Address2: | CITY OF FT LAUDERDALE HEALTH & WELLNESS CENTER | ||||||||
| City: | FT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333011046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7542062420 | ||||||||
| FaxNumber: | 9548675583 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 NE 3RD ST | ||||||||
| Address2: | CITY OF FT LAUDERDALE HEALTH & WELLNESS CENTER | ||||||||
| City: | FT LAUDERDALE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333011046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7542062420 | ||||||||
| FaxNumber: | 9548675583 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2006 | ||||||||
| LastUpdateDate: | 06/19/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ME0079403 | FL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 258343700 | 05 | FL | MEDICAID |