Healthcare Provider Details

I. General information

NPI: 1861788853
Provider Name (Legal Business Name): LEMUS NATURAL MEDICINE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 06/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11401 SW 40TH ST SUITE 120
MIAMI FL
33165-3372
US

IV. Provider business mailing address

11401 SW 40TH ST SUITE 120
MIAMI FL
33165-3372
US

V. Phone/Fax

Practice location:
  • Phone: 305-669-9689
  • Fax: 866-582-6015
Mailing address:
  • Phone: 305-669-9689
  • Fax: 866-582-6015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSE RAFAEL LEMUS
Title or Position: OFFICE MANAGER
Credential:
Phone: 305-669-9689