Organization
MD PROFESSIONAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LAZARO MOREIRA (PRES CEO)
(305) 242-9952
Entity
Organization
Contact information
Practice address
1235 N KROME AVE, R, HOMESTEAD, FL 33030-4204
(305) 242-9952
(305) 242-9998
Mailing address
1235 N KROME AVE, R, HOMESTEAD, FL 33030-4204
(305) 242-9952
(305) 242-9998
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
02/01/2012
Last updated
02/01/2012
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