Organization
MED LAKE CENTER LLC
Active
Other names
G & I Medical Research
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAYRA LOURDES ZENO MD (MEDICAL DIRECTOR)
(786) 332-4991
Entity
Organization
Contact information
Practice address
16371 NW 67TH AVE, MIAMI LAKES, FL 33014-6044
(786) 332-4991
(786) 409-2037
Mailing address
16371 NW 67TH AVE, MIAMI LAKES, FL 33014-6044
(786) 332-4991
(786) 409-6203
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
HCC11818
FL
Other
Enumeration date
06/30/2015
Last updated
10/13/2015
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