# LATINO MEDICASL CENTER 111 INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Latino medicasl center 111 inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467944421
- **Authorized official:** ENID LEON (CODER)
- **Authorized official phone:** (786) 797-6669

## Contact information

- **Practice address:** 3670 W OAKLAND PARK BLVD, LAUDERDALE LAKES, FL 33311-1148
- **Practice address phone:** (954) 716-6101
- **Mailing address:** 6422 NW 65TH WAY, PARKLAND, FL 33067-1503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | NULL | Yes |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2018
- **Last updated:** 06/16/2018