Organization
BLUE LAKE MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE GARCIA (CREDENTIALING DIRECTOR)
(305) 606-0337
Entity
Organization
Contact information
Practice address
2360 W 68TH ST STE 122, HIALEAH, FL 33016-5502
(305) 200-5705
(305) 392-1217
Mailing address
2360 W 68TH ST STE 122, HIALEAH, FL 33016-5502
(305) 200-5705
(305) 392-1217
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
03/07/2021
Last updated
03/07/2021
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