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General NPI Number Information
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NPI Number | 1639409923
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Entity Type | Organization
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Legal Business Name | LEZCANO MEDICAL CENTER INC
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 01/08/2010
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Provider Practice Location Address
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Address Line | 6501 NW 36TH ST STE 380
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6959
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Country | US
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Telephone | 305-526-1800
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Fax | 305-526-1801
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Provider Business Mailing Address
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Address Line | 6501 NW 36TH ST STE 380
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City | VIRGINIA GARDENS
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State | FL
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Zip | 33166-6959
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Country | US
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Telephone | 305-526-1800
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Fax | 305-526-1801
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Authorized Official
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Title or Position | PRESIDENT
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Name | OSKEL LEZCANO
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Credential |
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Telephone | 305-526-1800
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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 | HCC8631
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License Number State | FL
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