Organization
PROVIDER ASSOCIATES IPA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LUIS DE LAMAR (CEO)
(305) 606-6494
Entity
Organization
Contact information
Practice address
25865 SW 139TH PATH, HOMESTEAD, FL 33032-6696
(305) 606-6494
Mailing address
25865 SW 139TH PATH, HOMESTEAD, FL 33032-6696
(305) 606-6494
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
04/06/2023
Last updated
04/06/2023
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