Individual
MIRTA M. MEDEROS-LEZCANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7700 W SUNRISE BLVD # 200, PLANTATION, FL 33322-4113
(954) 838-2371
Mailing address
PO BOX 817737, HOLLYWOOD, FL 33081-1737
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME64316
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
262363300
—
FL
Enumeration date
02/09/2006
Last updated
03/26/2021
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