| NPI | 1619588324 |
|---|---|
| Former Legal Business Name | MIAMI LAKES DOCTOR'S LLC |
| Entity Type | Organization |
| Authorized Contact | YANET TEJEDA GARCIA President 786-797-7140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2021-07-20 |