Blue Lagoon Medical Center INC

NPI #1083097281 in Hialeah, Florida

Provider Information

NPI Number: 1083097281
Entity Type: Organization
Organization Name: Blue Lagoon Medical Center INC
Primary Specialty: Family Medicine
Enumeration Date: Jul 7, 2015
Last Updated: Jul 8, 2015

Practice Location

Address: 4355 W 16TH AVE STE 211A
City: Hialeah
State: Florida
ZIP Code: 33012-7670
Phone: (786) 304-9107

Authorized Official

Name: RICARDO MONTPELLER ACOSTA, MA
Title: PRESIDENT
Phone: (786) 304-9107

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X
Clinic/Center	261Q00000X
Family Medicine	207Q00000X	Primary

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