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Organization
POLICLINICO PASTORITA INC
Active
Organization
POLICLINICO PASTORITA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAZARA M SANCHEZ (ADMINISTRATOR)
(305) 860-0044
Entity
Organization
Contact information
Practice address
450 SW 8TH ST, MIAMI, FL 33130-2814
(305) 860-0044
(305) 860-0171
Mailing address
450 SW 8TH ST, MIAMI, FL 33130-2814
(305) 860-0044
(305) 860-0171
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ME49132
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
94846
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/15/2006
Last updated
02/09/2011
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