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Organization
SAN LAZARO MEDICAL GROUP, INC
Active
Organization
SAN LAZARO MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NIDIA D DOMINGUEZ APRN (VICE PRESIDENT)
(786) 294-0442
Entity
Organization
Contact information
Practice address
3271 NW 7TH ST STE 211, MIAMI, FL 33125-4141
(786) 294-0442
(786) 294-0124
Mailing address
3271 NW 7TH ST STE 211, MIAMI, FL 33125-4141
(786) 294-0442
(786) 294-0124
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/30/2016
Last updated
01/29/2021
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