Med Lake Center
NPI #1063814465 in Miami Lakes, Florida
Provider Information
- NPI Number
- 1063814465
- Entity Type
- Organization
- Organization Name
- Med Lake Center
- Primary Specialty
- Health Maintenance Organization
- Enumeration Date
- Sep 17, 2014
- Last Updated
- Sep 17, 2014
Practice Location
- Address
- 16371 NW 67TH AVE
- City
- Miami Lakes
- State
- Florida
- ZIP Code
- 33014-6044
- Phone
- (786) 332-4991
Authorized Official
- Name
- MRS. MARIA GISSELLE BOU, CEO
- Title
- CEO MANAGER
- Phone
- (786) 332-4991
Specialties & Taxonomy Codes
| Specialty |
|---|
| Health Maintenance Organization |
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