| NPI | 1841699584 |
|---|---|
| Former Legal Business Name | MED LAKE CENTER |
| Entity Type | Organization |
| Authorized Contact | MAYRA LOURDES ZENO Medical Director 786-332-4991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174V00000X Clinical Ethicist (Licence: FL ME62905) |
| Enumeration Date | 2014-08-19 |
| Last Update Date | 2014-11-17 |