| Med Lake Center Llc | |
|
16371 Nw 67th Ave Miami Lakes FL 33014-6044 | |
| (786) 332-4991 | |
| (786) 409-2037 |
| Full Name | Med Lake Center Llc |
|---|---|
| Speciality | General Practice |
| Location | 16371 Nw 67th Ave, Miami Lakes, Florida |
| Authorized Official Name and Position | Mayra Lourdes Zeno (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7863324991 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Med Lake Center Llc 16371 Nw 67th Ave Miami Lakes FL 33014-6044 Ph: (786) 332-4991 | Med Lake Center Llc 16371 Nw 67th Ave Miami Lakes FL 33014-6044 Ph: (786) 332-4991 |
| NPI Number | 1518340124 |
|---|---|
| Provider Enumeration Date | 06/30/2015 |
| Last Update Date | 10/13/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518340124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | HCC11818 (Florida) | Primary |
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