LIFE EXTENSION AND WELLNESS CENTER INC
NPI 1386912079
Internal Medicine in Dania Beach, FL

Q: What is Life Extension And Wellness Center Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since December 08, 2011CLIA 10D1105791 · Waiver

1418 S FEDERAL HWY, DANIA BEACH, FL 33004(954) 921-9555(954) 921-9556 Get Directions Write a Review

NPPES record last updated: November 21, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Life Extension And Wellness Center Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFE EXTENSION AND WELLNESS CENTER INC (NPI 1386912079) is a healthcare organization registered as an internal medicine in Dania Beach, Florida and active in the NPI registry since December 2011. The organization holds a CLIA Waiver certificate valid through September 28, 2027 and lists Laura B Burke, Mcc, as its authorized official.

NPPES Registry Identity

NPI1386912079

Entity TypeOrganization

Primary Taxonomy207R00000X

Legal Business NameLIFE EXTENSION AND WELLNESS CENTER INC

Location Address1418 S FEDERAL HWYDania Beach, FL 33004-4349

Mailing Address1418 S Federal HwyDania Beach, FL 33004-4349 · (954) 921-9555 · Fax (954) 921-9556

Phone(954) 921-9555

Fax(954) 921-9556

Organization SubpartNo

Authorized OfficialLaura B BurkeMcc · (954) 921-9555

Enumeration DateDecember 8, 2011

Last NPPES UpdateNovember 21, 2016

✔ NPI 1386912079 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

1418 S FEDERAL HWY, Dania Beach, FL 33004

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Other Identifiers 1

Medicare PINGI770AFL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1105791

Life Extension Wellness Center Inc Dba Extended Life Wellness Center · Dania Beach, FL

Active · expires Sep 28, 2027

CLIA Number10D1105791

Laboratory TypePractitioner Other

Certificate Effective DateSeptember 29, 2025

Certificate Expiration DateSeptember 28, 2027

Laboratory DirectorCarol Mclane

Laboratory Phone(954) 921-9555

Laboratory LocationLife Extension Wellness Center Inc Dba Extended Life Wellness Center213 E Sheridan St Ste 1, Dania Beach, FL 33004

CLIA data matches this NPI record on: Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EXTENDED LIFE PAIN & WELLNESS CENTER

Clinic/Center (Pain)

1418 S FEDERAL HWY
DANIA BEACH, FL 33004

Broward County (954) 921-9555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Life Extension And Wellness Center Inc's NPI number?

The NPI number for Life Extension And Wellness Center Inc is 1386912079. It was assigned to this organization in the NPPES registry on December 8, 2011.

Where is Life Extension And Wellness Center Inc located?

Life Extension And Wellness Center Inc is located at 1418 S Federal Hwy, Dania Beach, FL 33004. The listed phone number is (954) 921-9555.

What is Life Extension And Wellness Center Inc's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Life Extension And Wellness Center Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D1105791) is associated with this NPI, valid through September 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Life Extension And Wellness Center Inc was last updated on November 21, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.