Organization
VICENTE LAGO M.D. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICENTE LAGO M.D. (PRESIDENT)
(305) 541-1041
Entity
Organization
Contact information
Practice address
351 NW 42ND AVE, STE 305, MIAMI, FL 33126-5683
(305) 541-1041
(305) 541-7762
Mailing address
351 NW 42ND AVE, STE 305, MIAMI, FL 33126-5683
(305) 541-1041
(305) 541-7762
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
ME0024854
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037706600
—
FL
Enumeration date
12/10/2010
Last updated
12/10/2010
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