Healthcare Provider Details

I. General information

NPI: 1366478059
Provider Name (Legal Business Name): MARGARITA LERMO MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 07/01/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7821 CORAL WAY SUITE 121
MIAMI FL
33155-6542
US

IV. Provider business mailing address

PO BOX 558926
MIAMI FL
33255-8926
US

V. Phone/Fax

Practice location:
  • Phone: 305-446-1900
  • Fax: 305-446-1080
Mailing address:
  • Phone:
  • Fax: 305-262-6426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME33314
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberME33314
License Number StateFL

VIII. Authorized Official

Name: MARGARITA LERMO
Title or Position: DIRECTOR
Credential: MD
Phone: 305-446-1900