Healthcare Provider Details

I. General information

NPI: 1942041751
Provider Name (Legal Business Name): LPO MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2024
Last Update Date: 03/04/2025
Certification Date: 03/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9447 SW 56TH ST
MIAMI FL
33165-6421
US

IV. Provider business mailing address

9447 SW 56TH ST
MIAMI FL
33165-6421
US

V. Phone/Fax

Practice location:
  • Phone: 305-879-7673
  • Fax: 305-443-8230
Mailing address:
  • Phone: 305-879-7673
  • Fax: 305-443-8230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: NOEL AYMERICH FABRA
Title or Position: OWNER
Credential:
Phone: 786-534-4770