Healthcare Provider Details

I. General information

NPI: 1932369071
Provider Name (Legal Business Name): LIDIE LAJOIE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2008
Last Update Date: 05/31/2023
Certification Date: 05/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 BISCAYNE BLVD STE 880
MIAMI FL
33137-3235
US

IV. Provider business mailing address

PO BOX 577
CIRCLE PINES MN
55014-0577
US

V. Phone/Fax

Practice location:
  • Phone: 786-268-8289
  • Fax:
Mailing address:
  • Phone: 612-669-7173
  • Fax: 651-490-7797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD043751
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMD043751
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME137647
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: