MEDICARE: DAGMAR LEMUS MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053661652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAGMAR LEMUS MD PA

Provider Business Mailing Address
First Line	:	PO BOX 941852
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33194-1852
Country	:	US
Telephone Number	:	305-661-4250
Fax Number	:	305-667-2115

Provider Business Practice Location Address
First Line	:	4685 PONCE DE LEON BLVD
Second Line	:
City	:	CORAL GABLES
State	:	FL
Zip	:	33146-2108
Country	:	US
Telephone Number	:	305-661-4250
Fax Number	:	305-667-2115

Authorized Official
Title or Position	:	OWNER
Name	:	DAGMAR LEMUS
Credential	:	MD
Telephone Number	:	305-661-4250

Provider Enumeration Date	:	09/12/2012
Last Update Date	:	09/12/2012

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