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General NPI Number Information
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NPI Number | 1447562996
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Entity Type | Organization
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Legal Business Name | ALS MEDICAL GROUP INC
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Dates
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Enumeration Date | 07/12/2010
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Last Update Date | 07/12/2010
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Provider Practice Location Address
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Address Line | 8180 NW 36TH ST SUITE 301
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City | DORAL
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State | FL
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Zip | 33166-6645
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Country | US
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Telephone | 305-592-1409
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Fax | 305-592-1412
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Provider Business Mailing Address
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Address Line | 8180 NW 36TH ST SUITE 301
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City | DORAL
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State | FL
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Zip | 33166-6645
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Country | US
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Telephone | 305-592-1409
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Fax | 305-592-1412
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAZARO R SAAVEDRA
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Credential |
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Telephone | 305-592-1409
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | HCC 8784
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License Number State | FL
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