Organization
BLUE LAGOON HOSPITALISTS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN G. HOLTZCLAW MD (PRESIDENT)
(800) 424-3672
Entity
Organization
Contact information
Practice address
8900 N KENDALL DR, MIAMI, FL 33176-2118
(305) 596-1960
(305) 598-5960
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
Other
Enumeration date
03/03/2010
Last updated
03/03/2010
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