| Lourdes Selem Md Pa | |
|
5803 Nw 151 Street Ste 101 Miami Lakes FL 33014-2473 | |
| (305) 696-8802 | |
| (305) 696-8156 |
| Full Name | Lourdes Selem Md Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 5803 Nw 151 Street, Miami Lakes, Florida |
| Authorized Official Name and Position | Lourdes M Selem (PRESIDENT) |
| Authorized Official Contact | 7865048070 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lourdes Selem Md Pa 5803 Nw 151 Street Ste 101 Miami Lakes FL 33014-2473 Ph: (305) 696-8802 | Lourdes Selem Md Pa 5803 Nw 151 Street Ste 101 Miami Lakes FL 33014-2473 Ph: (305) 696-8802 |
| NPI Number | 1346653581 |
|---|---|
| Provider Enumeration Date | 06/05/2014 |
| Last Update Date | 09/05/2023 |
| Certification Date | 09/25/2020 |
| Medicare PECOS PAC ID | 2365669207 |
|---|---|
| Medicare Enrollment ID | O20140815002142 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346653581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | ACN325 (Florida) | Primary |
| Provider Name | Lourdes Selem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982809380 PECOS PAC ID: 0446479984 Enrollment ID: I20140916002389 |
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