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1730179045
MICHAEL THOMAS LAKE
MIAMI, FL
NPI
1730179045
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208600000X Surgery
(Licence: NC 2006-00950)
Additional Taxonomies
208600000X Surgery
(Licence: TX K8647)
Enumeration Date
2005-10-27
Last Update Date
2014-04-05
Business Address
Dr. MICHAEL THOMAS LAKE M.D.
5950 SW 81ST ST
MIAMI, FL 33143-8120
Phone number: 910-257-4406
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Mailing Address
Dr. MICHAEL THOMAS LAKE M.D.
5950 SW 81ST ST
MIAMI, FL 33143-8120
Phone number: 910-257-4406
Copy
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