Healthcare Provider Details

I. General information

NPI: 1881630788
Provider Name (Legal Business Name): GOOD FRIENDS MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8260 W FLAGLER ST SUITE 2B
MIAMI FL
33144-2069
US

IV. Provider business mailing address

8260 W FLAGLER ST SUITE 2B
MIAMI FL
33144-2069
US

V. Phone/Fax

Practice location:
  • Phone: 305-220-8580
  • Fax:
Mailing address:
  • Phone: 305-220-8580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: SERIOCHA LAZO
Title or Position: PRESIDENT
Credential:
Phone: 305-220-8580