Med Lake Center LLC

NPI #1518340124 in Miami Lakes, Florida

Provider Information

NPI Number: 1518340124
Entity Type: Organization
Organization Name: Med Lake Center LLC
Primary Specialty: General Practice
Enumeration Date: Jun 30, 2015
Last Updated: Oct 13, 2015

Practice Location

Address: 16371 NW 67TH AVE
City: Miami Lakes
State: Florida
ZIP Code: 33014-6044
Phone: (786) 332-4991

Authorized Official

Name: MRS. MAYRA LOURDES ZENO, MD
Title: MEDICAL DIRECTOR
Phone: (786) 332-4991

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
General Practice	208D00000X	Primary

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