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General NPI Number Information
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NPI Number | 1265472468
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Entity Type | Individual
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Provider Name | MYRIAM D LACAYO MD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 12/09/2022
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Provider Practice Location Address
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Address Line | 10250 SW 56TH ST STE C101
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City | MIAMI
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State | FL
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Zip | 33165-7065
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Country | US
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Telephone | 786-558-8901
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Fax | 305-558-8917
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Provider Business Mailing Address
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Address Line | 11301 SW 74TH TER
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City | MIAMI
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State | FL
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Zip | 33173-2601
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Country | US
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Telephone | 786-281-7505
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Fax | 305-595-8716
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME69826
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME69826
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License Number State | FL
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