DEPARTMENT OF INSURANCE

PR01928: LUMELIGHT
Experior Provider Number:	S17432
Provider Type:	Independent
Certification Date:
Address:	1515 W. CYPRESS CREEK TOAD STE RFR FORT LAUDERDALE, FL 33309
Contact:	LISA GOYETTE
Telephone:	608-518-4543
Status:	Active
Termination Date:	N/A