Healthcare Provider Details

I. General information

NPI: 1346429966
Provider Name (Legal Business Name): MIAMI LAKES HEALTH CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2007
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6447 MIAMI LAKES DR E SUITE# 223
MIAMI LAKES FL
33014-2741
US

IV. Provider business mailing address

6447 MIAMI LAKES DR E SUITE# 223
MIAMI LAKES FL
33014-2741
US

V. Phone/Fax

Practice location:
  • Phone: 954-214-6507
  • Fax:
Mailing address:
  • Phone: 954-214-6507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name: DR. LOUIS SCOTT ULIN
Title or Position: MEDICAL DIRECTOR
Credential: M.D
Phone: 954-214-6507