Organization
LAKE MEDICAL SERVICES INC
Active
Organization
LAKE MEDICAL SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS MARTINEZ (PRESIDENT)
(305) 557-8700
Entity
Organization
Contact information
Practice address
7980 NW 155TH ST, SUITE A, MIAMI LAKES, FL 33016-5818
(305) 557-8700
(305) 557-8715
Mailing address
7980 NW 155TH ST, SUITE A, MIAMI LAKES, FL 33016-5818
(305) 557-8700
(305) 557-8715
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
HCC8422
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FILE 8685
HCC AHCA EXEMPT
FL
Enumeration date
10/13/2010
Last updated
10/13/2010
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